What is an STI/STD?

Sexually transmitted infections (STIs) are diseases that FETAL EFFECTS:

are spread through sexual contact with an infected
partner. ➢ Preterm Birth ➢ Pneumonia

FIVE MODES OF TRANSMISSION ➢ Conjunctivitis

• Vaginal sex Treatment:
• Anal sex ➢ The infection can be cured with a single dose of
antibiotics.
• Oral sex
• Skin-to-skin contact ➢ Doxycycline (Vibramycin) therapy for nonpregnant
women (not recommended to use for pregnant women
• Infected Mother to child because it can cause a possible feta, long bone
deformities). Azithromycin (Zithromax) or Amoxicillin
There are 3 types of STIs (Amoxil) are used for pregnant women instead.
BACTERIAL STIs Diagnostic Test:
Bacterial STIs are caused by bacteria passed from • Urine Test • Swab
person-to-person during sexual activity. There are three
infections in this category: CHLAMYDIA, Prevention
GONORRHEA SYPHILIS, CANDIDIASIS
➢ Condoms ➢ Dental dams
CHLAMYDIA
➢ A person can get the infection again, so their partners
➢ Among the most common bacterial STIs in the world should also be tested
➢ Passed by having unprotected oral, anal or vaginalsex
GONORRHEA
➢ Most people have no symptoms
Symptoms: ➢ Sexually transmitted bacterial infection

o Abnormal vaginal/penile discharge ➢ Passed along by having unprotected oral, anal or

o White, yellow or gray/cloudy discharge that may be
strong odor
o Burning sensation when urinating
o Rectal pain, discharge, or bleeding
o Pain/swollen in one or both testicles
Can lead to:
❑ Sterility or infertility
❑ Infection of tube that carries sperm
❑ Pelvic Inflammatory Disease (PID)
❑ Long-term abdominal/pelvic pain
vaginal sex
➢ Transmitted by Neisseria gonorrhoeae, a
grampositive diplococcus, which thrives the mucous
membrane of the vagina or penis.
Symptoms:
Many women do not have symptoms. Those who do
have symptoms may experience:
▪ Burning during urination
▪ Rectal pain, itching, bleeding discharge
▪ Vaginal bleeding or pain
▪ Yellowish-white vaginal discharge

❑ Scar tissue formation in fallopian tubes

❑ Ectopic pregnancy
PREGNANT EFFECTS: Some men may have very mild symptoms or no
➢ Preterm Labor ➢ Premature ROM symptoms at all. Those who do may experience:
▪ Discharge from the penis
▪ Burning when urinating and affects the skin and mucous membranes of the
external genitalia and also sometimes in the mouth.
▪ Painful/swollen testicles
1. Acquired Syphilis (chancre) -.
Can lead to: Primary Syphilis
• Sterility or infertility Secondary Syphilis
Tertiary/Late Syphilis
• Disseminated infection (rash, fever, arthritis,
meningitis, etc.) • Tiny cuts or breaks in the skin or mucous membranes
of the external genitalia or
• Painful infection tubes attached testicles
• the mouth when their sexual contact including oral,
• Pelvic Inflammatory Disease (PID) anal, and vaginal sex
• Long-term abdominal/pelvic pain • sharing with contaminated needles
• Ectopic pregnancy • Direct contact with the skin lesion of an infected
person
• Scar tissue form in fallopian tubes
2. Congenital Syphilis
PREGNANT EFFECTS:
How is syphilis treated?
• Intraamniotic infection
•Preterm Labor ✓ A doctor will give you antibiotics – number of doses
depend on stage of infection (sexandu)
•Postpartum Endometrisis
✓ Avoid all sex (oral, anal, and/or vaginal) for 7 days
•Miscarriage after taking the medication – talk to your doctor
FETAL EFFECTS: ✓ Do not have sex with your current partner until they
• Preterm Birth are tested and treated

•Sepsis ✓ All sexual partners should be tested and/or treated

•Conjuctivitis CANDIDIASIS

Diagnostic Test: ▪ Gonorrhea nucleic acid amplification - yeast infection brought by the fungus candida.
test (NAAT)
- Low amount if candida in the body = harmless
Treatment and Prevention
- Weakened immune system = overgrowth of candida
• The antibiotic ceftriaxone given as an injection with
oral azithromycin (Zithromax)
• It can be prevented by latex condoms, should be used
consistently and correctly, can reduce the risk of
transmission of gonorrhea.
CAUSES OF OVERGROWTH OF THESE
SYPHILIS ORGANISM:
• TAKING ANTIBOTICS
• EXCESS MOISTURE IN THE VAGINA-
• HIV
• DIABETES
What CAUSES yeast infections during
PREGNANCY?
Treponema pallidum is a gram-negative bacterium that • Hormonal changes that come with pregnancy or before
causes syphilis. Syphilis is a sexually transmitted disease your period
• Taking birth control pills ▪ Abnormal thin vaginal/penile discharge white, yellow
or green with foul odor
• Taking antibiotics or steroids
▪ Burning urinating and ejaculation
TYPES OF CANDIDIASIS
▪ Genitals itching, sore, red, burning
1. OROPHARYNGEAL CANDIDIASIS
PUBIC LICE
2. GENITAL YEAST INFECTION
(VULVOVAGINITIS) Cause by the PTHIRUS PUBIS
SYMPTOMS ▪ The lice attach their eggs to the pubic hair and feed on
human blood.
• Redness or swelling on the outside of the vagina
▪ Spread by sexual contact, Hugging, kissing, sharing
• Itching clothes, towel
• Burning SYMPTOMS:
• Pain when urinating ▪ Extreme itching in the genital region
• Painful sexual intercourse ▪ Low grade fever
• Thick white vaginal discharge ▪ Pale bluish spot near the bites
DIAGNOSIS DIAGNOSIS:
Oral candidiasis- confirmed with culture, tissue biopsy ▪ By visual examination of the affected area with a
TREATMENT magnifying glass

- ORAL TRUSH (ORAL NYSTATIN SUSPENSION) SCABIES

- VULVOGINITIS (TOPICAL ANTIFUNGALS)
- RESISTANT INFECTIONS TREATED
AZOLE ANTIFUNGALS MEDICATIONS.
PARASITIC STIs
TRICHOMONIASIS
▪ Caused by Trichomonas vaginalis.
▪ Spread by unprotected sexual intercourse. It nests in
the female lower genital tract, such as the CERVIX,
URETHRA, OR BLADDER.
In men it resides in the URETHRA AND PROSTATE.
SYMPTOMS
▪ Up to 70% of cases are asymptomatic
▪ Symptoms appears 5-28 days after the initial infection.
▪ VAGINAL DISCHARGE
▪ Acute irritation ▪ Inflammation
In pregnant women, Trichomoniasis may lead to a
premature delivery.
Symptoms:
Caused by the itch mite. It burrows just under the skin
and lays eggs.
WITH
- Can live for 2-4 days away from the human body; it
can be transmitted without sexual contact. Scabies can
be found on other parts of the body – usually the hands,
wrist, chest and waistline
SYMPTOMS:
TWO TYPES:
CLASSIC AND CRUSTED CLASSIC SCABIES
▪ Eruption of small erythematous papules (appears of
knot on a rope)
▪ Pruritic CRUSTED SCABIES
▪ Also known as Norwegian Scabies
▪ Occurs in patients with immunosuppression (HIV
patients, older patients, lymphoma)
DIAGNOSIS
▪ Detection of the mites and/or eggs by microscopy
How to prevent parasitic STIs?
Trichomoniasis
• Condoms will help prevent the spread Pubic lice and • Skin lesions and scarring, IUGR
Scabies
Treatment:
•Avoid sharing towels and clothing that have not been
washed • Small warts can be removed by applying podophyllin
(Podofin), a wart removal medication.
• When trying on bathing suits or underwear in the store
always wear something underneath Signs and symptoms • Large lesions are removed by laser therapy,
of a parasitic STI cryocautery, laser, or knife excision. With cryocautery,
edema at the site is evident immediately; lesions become
• Intense itchiness dangerous, and sloughing occurs in 7 days
• Reddish rash Prevention:
• Pain during sex or urination • Yearly Pap tests
• Vaginal discharge • Men should conscientiously inspect their penis for any
abnormal growths or ulcers. Vaccine are available for
How are parasitic STIs treated? grade 7 students to prevent HPV.
• Shampoo Pregnancy and Human Papillomavirus Infection.
• Lotion • HPV lesions tend to increase in size during pregnancy
• Ointment because of the high vascular flow in the pelvic area.

• Antibiotic • The presence of vulvar lesions appears to have no

VIRAL STIs
HUMAN PAPILLOMA VIRUS
• Very contagious virus
• Some people never get symptoms
• HPV is spread through skin to skin contact, oral, anal
and vaginal sex with an infected partner
• Some types cause genital warts and other types can
cause cancer of the cervix.
• There is NO TREATMENT for HPV, but there are
treatments for the health problems that HPV cause:
Cervical PreCancer, Genital warts, Other HPV-
related cancers.
Sign/Symptoms:
• At first, lesions appear as discrete papillary structures;
then they spread, enlarge, and coalesce to form large,
cauliflower-like lesions.
• Excessive or abnormally milky, yellow discharge and
foul smelling.
• Warts (Genitals, Common, Plantal)
Maternal Effects:
• Nausea, Headache, Miscarriage, Preterm Labor, Still
birth
Fetal Effects:
effect on the fetus during pregnancy, but if they are so
large they obstruct the birth canal for birth, a cesarean
birth may be scheduled.
HERPES
Caused by the Herpes Simplex Virus (HSV)
• Spread through skin to skin contact and oral, anal and
vaginal sex
• Some people with herpes never develops sores, but are
still contagious and may spread it to others without
knowing
• People who have an initial outbreak can have more
outbreaks throughout the rest of their life
2 types of HSV:
Type 1(cause cold sore),
Type 2( cause genital infection).
TYPES OF HSV:
• HSV1 (oral herpes) - develop oral herpes, that leads to
development of fever blisters and cold sores on the face
and around the mouth.
• HSV2 (genital herpes) - caused blisters and sores on
the genital area
Symptoms:
• Itching, tingling, or burning feeling in the vaginal or
anal area
• Flu-like symptoms, including fever
• Swollen glands “Hepatitis” means inflammation of the liver: The liver is
a vital organ that processes nutrients, filters the blood,
• Pain in the legs, buttocks, or vaginal area and fights infections. When the liver is inflamed or
• A change in vaginal discharge damaged, it may not be able to function properly.

• Headache
• Painful or difficult urination
• A feeling of pressure in the area below the stomach
•After a few days, painful sores, blisters, or ulcers may
develop where the virus entered the body.
Assessment:
• Herpes is diagnosed by culture of the lesion secretion
from its location on the vulva, vagina, cervix, or penis or
by isolation of HSV antibodies in blood serum.
• On the first contact, extensive primary lesions originate
as a group of pinpoint vesicles on an erythematous base.
SYMPTOMS:
• Within a few days, the vesicle ulcerates and become
moist, painful, draining, and open lesions. It is HAV STAGE 1: PRODROME Anorexia, nausea and
accompanied with flu-like symptoms with increased vomiting, fever, fatigue, malaise, myalgias
temperature.
STAGE 2: ICTERIC PHASE (ICTERIC=JAUNDICE)
• Diagnosis of the disorder is made by the appearance of
• Dark urine
the lesions and on the results of a Pap smear and an
enzyme-linked immunosorbent assay (ELISA) • Pale stool
• Jaundice (it occurs because of high bilirubin, RUQ
pain/ discomfort, pruritus’
HBV Acute hepatitis B
Symptoms:
• Flu like symptoms
Diagnostic Test:
• Fatigue
• Spinal Fluid
• Vomiting
• Blood, Urine or Tear test
• Poor appetite
• PCR test ( recommended for neonates and for cases in
which encephalitis and bloodborne infection is • Joint paints
suspected)
• Headache
Therapeutic Management
• Dark urine
• Acyclovir (Zovirax) and Valacyclovir (Valtrex) are
examples of antivirals that can control the virus by • Enlarged liver
interfering with DNA reproduction and decreasing
• Yellow skin and eyes
symptoms.
• Weight loss
• Topical imiquimod (Aldara) or foscarnet (Foscavir)
may be prescribed for resistant lesions. • Warm baths COMPLICATIONS
three times a day may helpful to reduce discomfort for
the patient. • Scarring of the liver (cirrhosis)

HEPATITIS A & B • Liver cancer

• Liver failure
• Reactivation of hepatitis B virus
• May develop kidney disease or inflammation of blood
vessels
HIV/AIDS
Chronic liver failure
Human Immunodeficiency Virus (HIV) and Acquired
Symptoms: Immunodeficiency Syndrome (AIDS) HIV is considered
a chronic disease with many people living with HIV
• Asymptomatic having a normal life expectancy. This can happen with
• Hormonal changes specialized multidisciplinary healthcare. There is no cure
for HIV/AIDS however there are some treatments to
• Fatigue slow the progression of the disease (antiretroviral
therapy).
• Vomiting
How is HIV/AIDS spread?
• Poor appetite
▪ Spread by exposure to blood and/ or other body
• Jaundice
secretions through sexual contact,
• Cirrhosis
▪ the sharing of contaminated needles for injection,
• Ascites
▪ the transfusion of contaminated blood or blood
• Peripheral edema products, perinatally from mother to fetus,

• Liver cancer ▪ and possibly through breastfeeding.

▪ Children can also acquire to infection because of
sexual maltreatment.

Prevention:
• Get vaccinated against Hepatitis B (available for
students in grade 7)
• Practice safer sex
• Do not share instruments used in body-piercing,
tattooing or hair removal 3 categories of HIV infection in children according to
Center Disease Control: Category A, Category B,
• Do not share personal items such as toothbrushes,
Category C
razors and needles
Assessment
Why would it be unsafe to share toothbrushes,
razors, personal care items? ▪ In children and infant, the disorder appears to progress
more rapidly.
- Hepatitis B and C can be spread through blood and
bodily fluids - Personal care items can have small ▪ HIV incubation period for adults last about 10 years.
amounts of blood or bodily fluids on them even if you
can’t see the blood (e.g. have you ever tasted a little ▪ Children who receive the viral via placental
blood after brushing and flossing, but didn’t see the transmission usually a HIV positive by 6 months and
blood on your toothbrush?)
develop clinical signs of the disease by 1 to 3 years of ▪ Safer sex behavior.
age.
▪ Management of infection.

▪ During the reconversion time, a child may display

preliminary symptoms such as poor resistance to
infection, fever, swollen lymph nodes, respiratory tract
infections, and oral candidiasis. ➢ Acute pain/impaired tissue integrity related to:

Screening and Diagnosis ▪ Effects of the infection process

Screening, teaching, and counseling regarding HIV risk ▪ Scratching (excoriation) of pruritic areas.
factors, indications for being tested, and testing are
▪ Hygiene practices
major roles for nurses caring for women today. A
number of behaviors place women at risk for HIV ➢ Sexual dysfunction related to:
infection, including intravenous drug use, high risk
sexual partners, multiple sex partners, and a previous ▪ Effects on infection process
history of multiple STIs. HIV infection is usually
diagnosed by using HIV-1 and HIV-2 antibody tests. ➢ Social isolation and impaired social interaction
Antibody testing is first done with a sensitive screening related to:
test such as the enzyme immunoassay (EIA). Reactive ▪ Perceived effects on relationship with others with STI
screening tests must be confirmed by an additional test, status is unknown.
such as the Western blot or an immunofluorescence as-
say.
Management
Routine gynecologic care for HIV-positive women
should include a pelvic examination every 6 months.
Careful Pap screening is essential because of the greatly
increased incidence of abnormal findings. In addition,
HIV-positive women should be screened for syphilis,
gonorrhea, chlamydia, and other vaginal infections.
Confection with syphilis is common in HIV-infected
women, and unusual serologic responses have been
documented among HIV-infected persons who have
syphilis (CDC, 2002b). Because treatment failures with
benzathine penicillin are common, follow-up and
evaluation must be done at 3, 6, 9, 12, and 24 months
after therapy. Further-more, HIV infection increases
susceptibility to neurosyphilis, which is difficult to
differentiate clinically from HIV dementia.
NURSING DIAGNOSIS

➢ Anxiety/Situational low self-esteem/disturbed body

image related to:
▪ Perceived effects on sexual relationships and family
process.
▪ Possible effects on pregnancy/fetus.
▪ Long-term sequalae of infection.

➢ Deficient knowledge related to:

▪ Transmission/prevention of infection/re-infection.