Sexually Transmitted Infections

Common Signs of Sexually Transmitted Infections Males Females Pus or clear discharge from the penis. Penis may feel itchy. A burning sensation while urinating. Sores around the genital region, anus, and/or throat. -More vaginal discharge than normal. -Green or yellow discharge from the vagina. -Odor coming from the vagina. -Sores around the genital region, cervix, anus and/or throat. -An itch or burning feeling around the genital region. -A burning sensation while urinating. -Pain in the lower abdomen.

Chlamydia Symptoms -Appears 2 days -6 weeks after being infected. -May never have symptoms (3). -75% of women(W), 50% of male(M) cases are asymptomatic (2). W- Unusual discharge from vagina. Vagina bleeding/spotting between periods. Bleeding or pain during/after sex. Abdominal or lower back pain. Burning feeling when urinating. -M- Clear or milky discharge from penis. Pain or swelling in testicles. Burning feeling when urinating. Itchy feeling inside of penis (2) (3) (4). Diagnosis -Urine test -Pelvis exam, with swabs from the cervix, urethra or rectum (2)(3). Treatment -Curable with azithromycin or doxycycline (10). -If not treated leads to: M- urethral damage, epididymitis, Reiter’s syndrome. W- Pelvic inflammatory disease, possibly infertility due to scaring of the fallopian tubes (2). Prevention -Regular screening. -Consistent use of a condom (2). -Do not have sex 7 days after medication is finished because re-infection can occur (3) (4).

University of Southern Mississippi. (2006).

Human Papillomavirus (HPV) Symptoms -Majority asymptomatic . -Abnormal cells on the cervix (6) and/or warts, which appear 3-8 months after intercourse with infected person (2). Diagnosis -Inspection of the warts. -Abnormal cells on a Pap test Treatment -Repeated podophyllin or bichloroacetic acid (BCA) applied directly to wart. -Liquid nitrogen to freeze them off. -Final resort is laser therapy (10). Prevention -Use of condoms, but the virus is still small enough to pass through the condom (2). -Regular yearly Pap tests every 6 months for several years(10), and follow-ups can successfully reduce mortality from that malignancy (1).

University of Southern Mississippi. (2006).

Genital Herpes -Herpes Simplex Virus (HSV) 1- is found mostly in areas above the waist (cold sores). HSV 2- is found mostly n areas below the waist (genital herpes). -Type 1 can sometimes cause genital herpes and type 2 cause cold sores (5). -Transmitted by vaginal, oral, or anal sex (8). Symptoms Primary stage- 2-8 days after infection. -One or small groups of small painful bumps/blisters appear (2)(5). Fluid in blisters may be clear or cloudy; area under blister will be red. Blisters break open easily and become tender and sore (5). Painful urination, fever, headaches and other flu like symptoms (2). -Some people will be asymptomatic, and be unknowingly caring the virus (2)(5). -Very infectious in this stage (5). Latent stage- No blisters, sores or other symptoms. The virus travels from skin to the nerves in your spine were it becomes dormant. Shedding stage- Virus multiplies in the nerves; gets into body’s fluids (saliva, semen or vaginal fluids). -No symptoms in this stage, but is still infectious (5). Recurrence- feeling of itching, tingling or pain can signal an attack. -Usually symptoms are not as bad as the first time. -Stress, sickness, menstrual period, being in the sun may cause a recurrence (5). -Symptoms occur unpredictably. Average recurrent per year is 4. -“No safe period” (2).

-No cure, but can be treated with medication (5) such as, acyclovir. Diagnosis -Regular screening. -Blood tests. -Pelvic exam with swabs from the cervix, urethra, rectum and/or throat(2)(3). Treatment -No cure, but can be treated with medication (5) such as, acyclovir. -Valacyclovir and famciclovir more effective in shortening outbreaks/suppressing recurrences (2). Prevention -Even with no symptoms, individual is still infectious. -Practice safe sex; always wear a condom. -Do not have intercourse when there are symptoms(2). No author. (n.d).

Gonorrhea Symptoms Diagnosis Treatment Prevention -Appear 5-8 days after infection. -50% of males and females are asymptomatic (8). -M- urethritis (inflammation of the urethra), a think, clear mucous discharge seeps out of the meatus. Within a couple days it becomes thick and creamy; may be white, yellowish or yellow-green (purulent). Area around the meatus becomes swollen. Painful burning sensation while urinating; urine may contain pus or blood; lymph glands or groin may become enlarged or swollen (2). Intercourse is painful (8). -F- Asymptomatic in early stages. Pus discharge (amount may be so slight it is unnoticeable). Inflammation may cause a burning sensation while urinating (2). Pain during intercourse (8). Diagnosis -Swab of infected area or urine test (8). -Pelvic exam (2). Treatment Infection has the ability to acquire antimicrobial resistance to medications, such as Penicillin (1). Curable with the antibiotic cifixime (2). Consequences of not getting treatment: M- have early symptoms and are more painful. If not treated, the urethritis spreads up the urethra, causing inflammation of the prostate, seminal vesicles, bladder, and epididymis (2)(if untreated can cause infertility)(8). F-left untreated, fallopian tubes can become inflamed (Pelvic Inflammatory Disease). If PID is not treated, scar tissue forms and can cause infertility (2). Prevention -Regular screening. -Safe sex practices and use of condoms.

No author. (n.d).

Syphilis Symptoms Primary stage- A chancre appears about 3 weeks after infection (or as early as 10 days, late as 3 months). It is a painless, round, ulcer like lesion with a hard raised edge. (Resembles a crater). The chancre appears wherever the infection entered the body (penis, cervix, mouth, rectum, lips; rare through a cut) (2). If untreated will go away in 1-5 weeks, but infection is still in the body. Secondary stage- 1-6 months after appearance of chancre, generalized body rash develops (on palm of hands, sole of feet etc.); does not itch or hurt (beginning of 2nd stage). Hair loss can occur. Symptoms go away in 2-6 weeks. Latent stage- May last for years. Infection is burrowing into the bodies tissue; blood vessels, brain, spinal cord and bones. No symptoms in this stage. After 1st year no longer infective, except pregnant women to fetus. Half of people stay in this stage permanently with no further complications Late Stage- Heart and major blood vessels are attacked leading to death, insanity, paralysis. Appear 10-20 years after infection (2) (8). Diagnosis -Physical exam of entire body and a blood test. W- Pelvic exam Treatment -Disease can still be cured in secondary stage with no permanent effects with the use of penicillin, tetracycline or doxycycline. Prevention -Regular yearly physicals, including pap test. -Practice safe sex measures and use of a condom (2).

Health Awareness Connection. (n.d).

Trichomoniasis Symptoms -Appear 4-28 days after infection (7). -F- abundant, frothy white or yellow discharge. -Unpleasant odor(2). Vaginal itching. -Pain during sex or urination (6). -M-Slight discharge and irritation of urethra (2). -Burning feeling when urinating (7). Diagnosis -Pap exam with vagina swab. -Men are not commonly tested from this STI (8). Treatment -Curable wit metronidazole (7). Prevention -Practice safe sex measures. -Regular physical exams and pelvic exams. -No sexual contact until medication is completed and symptoms are gone (7).

Urgent Care Service of South Florida. (n.d).

Hepatitis B -Virus that affects the liver. -Found in salvia, blood, semen, and vaginal fluid. -Transmission by sexual contact, sharing items such as, toothbrush, razor, or needles. Symptoms -Tiredness, nausea, pain in abdomen, loss of appetite. -Darker urine; lighter colored stool . -Jaundice. -Sometimes asymptomatic (8). Diagnosis -Blood test. Treatment -No cure. -Many fight the infection naturally after several weeks or months (8). Prevention -Hepatitis B vaccination available. -Do not share items such as, toothbrush, razor, or needles. -Practice safe sex, and wear a condom (8).

Most Common Modes of STI Transmissions 1. Sexual contact with an infected partner with no condom 2. Blood transfusion and/or contact with a cut in the skin or infected blood products 3. Sharing of needles and razors etc 4. Mother to child (pregnancy, delivery, and breastfeeding) Oral, vaginal, and anal sex without a condom Pregnancy, delivery or breastfeeding Contact with blood by: a cut in the skin, needles, razors etc.

Risk for STIs Low Risk High Risk: Test for STIs No low Yes HIGH No low 1) I have symptoms/my partner has symptoms of an STI 2) I have been exposed to an STI 3) I have questions and/or concerns about STIs 4) In the last 12 months have you had more than 1 sexual partner? If in high risk area, test patient for STIs 5) In the past 12 months has your partner(s) had more than one sexual partner? 6) In the last 12 months have you been diagnosed with an STI? 7) In the past 12 months how often do you use a condom? If answered “yes” to any one question from 1-3 assume high risk No low Yes HIGH No low Yes HIGH No low Yes HIGH Always low Sometimes HIGH Never

Nursing Interventions Increase knowledge and prevent spread of disease Education about how to take preventative measure to decrease the spread of STI’s. Discuss risk factors, and emphasize behaviors that lead to STI transmission (unprotected sex, sharing of needles, etc.). Make sure information given and or explained is appropriate depending on age group, gender, culture etc. so that the particular group or individual can fully understand STI information and how to prevent the spread of disease. Discuss the value of condoms, and how they reduce the risk of STI’s. Explain to the infected person what organism caused the infection, what signs and symptoms to look for, and possible complications. The nurse should stress the importance of following through, and finishing any medication given for STI infections, and not to partake in sexual activity while on medication or a week after finishing medication. Increasing compliance Openly discuss and communicate in a non-judgmental manner about STI information, and facilities that are accessible when wanting more education, teaching or information about STI’s. Discomfort when dealing with STI’s can be decreased when explanations of the different causes, consequences, treatments, preventative measure are discussed openly.