Unit 12 - Sexually Transmitted Infections

Examples of viral STIs

HIV, Hep B and C, HPV, HSV2

bacterial STIs

chlamydia, gonorrhea, syphilis

other STIs

cadidiasis (yeast)

trichomoniasis (protazoa)

S&S of gonorrhea in males

urethritis, purulent discharge, urinary frequency

S&S of gonorrhea in females

urinary frequency, purulent discharge

complicated gonorrhea can result in

epididymitis in males and pelvic inflammatory disease in females

treatment for gonorrhea

who gets treated?

ceftriaxone (Rocephin)

the patient who has it and sexual partners of the past 60 days

chlamydia S&S in males

same as gonorrhea

chlamydia S&S females

vaginal discharge, cervicitis (maybe), and progress of symptoms

why is chlamydia called the silent disease?

it is asymptomatic in 90% of men and 70% of women

treatment of chlamydia

doxycycline, azithromycin, levofloxacin

when do sx of chlamydia show up?

1-3 weeks after exposure

how to diagnose gonorrhea and chlamydia?

bacterial culture

sign of primary stage of syphilis 

painless chancre that lasts for 3-6 weeks and heals spontaneously

why does secondary syphilis happen?

it enters the lymphatic system - so a lot of symptoms are lymph related

sign of secondary syphilis

rash on hands and feet

how long can latent syphilis happen (symptoms go away but the bacteria still lives in the body)

6 months to years

subcategories of tertiary syphilis

neurosyphilis, cardiovascular, and gumma (lesions on bones, skin, and mucous membranes)

how dangerous is congenital syphilis?

can cause stillbirth, blindness, facial abnormalities, paralysis 

how is syphilis treated?

benzathine penicillin G 2.4 million units IM

1 dose if stage 1 or 2 and 2 doses if stage 3

treatment for genital herpes

acyclovir, valcyclovir

is genital herpes acute or chronic?

chronic. educate the patient to practice safe sex

how does genital HPV present?

painless cauliflower appearance-elevated growth/textured lesions

treatment for HPV

no absolute cure but can remove the lesions

trich S&S

males are asymptomatic

females have frothy, bubbly green discharge and painful sex

treatment for trich

metronidazole

what to teach your patient on metronidazole?

no alcohol at all

risk factors for bacterial vaginosis

multiple sex partners, common douching

how is BV discovered and diagnosed?

pt typically complains of fishy odor

diagnoses by whiff test and microscope examination

what does BV or ANY STI increase a patient’s risk for?

another STI. inflammation compromises tissue integrity

what trends are seen in incidence and prevalence of HIV?

both are rising. new cases are appearing in younger patients and people are living longer with it

HIV stage 1 symptoms

flu-like symptoms and rash

when is antibody testing for HIV effective?

antibodies can be detected 6 weeks-3 months

CDC criteria for stage 3 HIV

wasting syndrome

T cells below 200

AIDS dementia complex

Opportunistic infection

Opportunistic cancer

examples of opportunistic infections with HIV

pneumocystic jiroveci pneumonia, oral candidiasis, pulmonary TB, cervical cancer, Kaposi Sarcoma, lymphoma

how is HIV transmitted?

sexual contact, needle sharing, perinatal transmission, blood transfusions (rare because of screenings now)

recommendations for HIV screening

everyone 13-64 should get screened once

people at risk should be annually screened

all pregnant women get screened

drawbacks with anonymous HIV screening?

no good avenue for follow up care and it’s hard to track demographic data

HIV testing methods

antibody test, Western Blot (blood), rapid antibody test

how often does a patient with HIV have to take their medication

every single day

if doses are missed, the virulence and resistance of the virus increases

how often does PREP have to be taken? how long does it take to reach maximum protection?

every day

about a week

how is Hep B prevented?

immunizations, infection control, safe sex education, OSHA mandates

who is at high risk for contracting hep b?

IV drug users, people with multiple sex partners, people with STDs, immigrants, healthcare workers, people on dialysis, inmates

what are risks associated with hepatitis c?

liver cirrhosis, cancer and death

what is the best way to assess a patient’s risk and guide them on changing behaviors?

one on one counseling