STI Flashcards
Bacterial
Bacterial Infections Chlamydia Gonorrhea Syphilis Parasitic/Protozoan Trichomoniasis
Prevalence
All cases present during a given time period
Includes new and pre-existing cases
Incidence
New cases that occurred during a given time period
Does NOT include pre-existing cases
Chlamydia
Pathophysiology Caused by gram-negative bacteria Chlamydia trachomatis Transmitted by exposure to sexual fluids during vaginal, anal or oral sex Symptoms Usually no symptoms Men Women Rectal Complications Male infertility Female pelvic inflammatory disease
Diagnostics and Treatment
Sexual history and physical exam
NAAT swab of urethra, vagina, rectum or oropharyngeal
Antibiotics
Treat all partners from past 60 days as well
Expedited Partner Therapy (EPT)
Abstinence for 7 days
Use condoms or barrier methods for prevention
Gonorrhea
Pathophysiology Caused by Gram negative bacterium Neisseria gonorrhoeae Transmitted by exposure to sexual fluids during vaginal, anal or oral sex. Symptoms Usually asymptomatic Men Women Rectal Oral
Complications
Male infertility from epididymitis
Female pelvic inflammatory disease (PID)
Gonococcal conjunctivitis in neonate
Diagnostics and Treatment Sexual history and physical exam NAAT swab Dual antibiotics Treatment of partners Abstinence for 7 days
Syphilis
Pathophysiology Caused by bacterium Treponema pallidum Transmitted by direct contact with syphilitic lesion Symptoms (Lewis Table 52-6) Primary Secondary Latent Tertiary (Late)
Congenital
Transmitted via placenta
Diagnostics and Treatment Sexual history and physical exam Blood tests Antibiotics Treatment of partners from past 90 days
Genital Herpes
Pathophysiology Lifelong, incurable infection Caused by herpes simplex virus (HSV) type 1 or type 2 Transmitted by direct contact with mucous membranes or skin when an infected individual is symptomatic (lesions present). Symptoms Primary episode (stages) Prodromal Vesicular Ulcerative Final Recurrent episodes
Triggers Stress, fatigue, sunburn Illness, immunosuppression Menses Complications Blindness Encephalitis or meningitis Congenital HSV Negative impact on well-being Diagnostics and Treatment Sexual history and physical exam Culture of lesion Blood work—virus antibodies Antivirals Symptomatic care
Genital Warts
Pathophysiology Caused by human papillomavirus (HPV) Transmitted by skin-to-skin contact during vaginal, anal or oral sex; also can be transmitted during outercourse. Symptoms Usually asymptomatic Warts Men Women
Complications Cancer Psychosocial Diagnostics Sexual history and physical exam Cervical HPV testing Women aged 30 or older Biopsy of growth Prevention HPV vaccine
Primary prevention
Community education about prevention
Community outreach for education and needle exchange
Vaccinate (Hepatitis, HPV)
Assess for risk behaviors and potential exposure
Use 5 P’s approach to sexual history
Education about changing behavior to reduce risk (Lewis Table 52-10)
Condoms/barrier methods with every sexual encounter
Being monogamous
Asking potential partners about sexual history
Asking potential partners if they have been tested for STIs
Avoiding sex with partners that use IV drugs or have visible oral, inguinal, genital, perineal or anal lesions
Secondary Prevention
Screening for diseases to ensure their early identification, treatment and follow-up with contacts to prevent future spread
STI screening (e.g. HIV test)
Client teaching after diagnosis
Managing symptoms
Avoiding re-infection
Preventing infection of others
Partner notification (contact tracing)
Population-level intervention to control communicable diseases
Identify and notify exposed individuals of clients (+) for reportable diseases—encourage to seek treatment; stop chain of infection
Tertiary Prevention
Treatment, symptom management and psychosocial support
Treat acute infections
Manage symptoms or acute exacerbations of chronic diseases
Identify community resources for providing supportive care
Support groups for those with chronic infections
