Refer

to a variety of clinical syndromes caused by pathogens that can be acquired and transmitted primarily through sexual activity. (CDC) Until the 1990s, commonly known as Venereal Diseases Veneris Venus In recent years, Sexually Transmitted Infections has been preferred.

Infection simply means that a

germ virus, bacteria, or parasite that can cause disease or sickness is present inside a persons body.

An infected person does necessarily have any s/s that the virus or bacteria is actually hurting his or her body.

not

disease means that the infection

is actually causing the infected person to feel sick, or to notice something is wrong.
STI refers to infection with any

germ that can cause an STD, even if the infected person has no symptoms.

STATISTICS
The

incidence of STDs continues to ________ worldwide, and infections are becoming ___________.

STATISTICS
The

incidence of STDs continues to increase worldwide, and infections are becoming more severe. Thus the scope of the health problem they create is increasing rather than decreasing. It is a matter of public concern that treatments for STIs be:
? ? ?

STATISTICS
The

incidence of STDs continues to increase worldwide, and infections are becoming more severe. Thus the scope of the health problem they create is increasing rather than decreasing. It is a matter of public concern that treatments for STIs be
safe, inexpensive, effective.

and

STATISTICS
Except

for the common cold and influenza,

most prevalent communicable infections in the US. Symptomatic STDs are diagnosed in
STIs are the more than 15 million people in the US annually, not including HIV infection and AIDS, and 86% of affected people are between 15

and 29 years of age.

STATISTICS
Another

40 million people are affected

with human papillomavirus (HPV), which causes

genital warts.

It is estimated that 50%

of all

Americans will have been exposed

to or will contract an STI by age

30 years.

STATISTICS
The

worldwide increase in the incidence of STIs is a result of many factors.

The

use of intrauterine devices (IUDs) and oral contraceptives may lower womens resistance to infection and facilitate STI transmission. Women may not think to use an infection barrier in addition to effective contraception. Sterilized women often do not use condoms.

STATISTICS
The

worldwide increase in the incidence of STIs is a result of many factors.

Antibiotic-resistant

strains of bacteria have become more common. Many people have a cavalier attitude about infection and illness in general. Politics and religion continue to affect the controversy over sex education in schools.

STATISTICS
The

worldwide increase in the incidence of STIs is a result of many factors.

Lack

of knowledge also plays a role in the incidence of STIs. Accurate information about sex and STIs is not always presented in a manner designed for young people. Information presented to children and adolescents must take into account their age, developmental level, and culture.

HIV/AIDS IN THE PHILIPPINES

2008 92,200,000 People living with HIV/AIDS, 2007
Population,

8,300
(aged 15+) with HIV/AIDS,

Women

2007 2,200
AIDS

deaths, 2007 <200

Source: Population Reference Bureau & UNAIDS

 More

than 50 organisms are known to spread through sexual activity. 5 most widely known STIs: Chlamydia Gonorrhea Syphilis Genital Herpes Genital Warts

The

number of STIs is increasing as new agents are implicated in the sexual transmission of disease.

STIs

share the following cgaracteristics: 1. STIs can be transmitted by any

sexual activity
between oppositesex or same-sex partners

2. Having one STI confers no

immunity
against future reinfection with
that STI or with any other STI

3. Sexual

partners
need to be

of

infected clients

assessed for

treatment

4. STIs affect people

from

socioeconomic classes, cultures, ethnicities, and age-groups

all

5.

bear a disproportionate number of the

effects of STIs

Women

6.

Frustration, anger, anxiety, fear, shame,

and guilt are

common emotions

associated with an STI diagnosis.

Sexually

transmitted infections are a common source of morbidity for adolescents and young adults (Crosby & Danner, 2008). Estimates suggest that about 48% of nearly 19 million cases of sexually transmitted infections occurring annually in the United States are acquired by persons aged 15-24 years

STDs

can be symptomatic or asymptomatic. High portion of STD cases are asymptomatic; for example, as many as 85% of women with chlamydial infection are asymptomatic ( Tilson et al., 2004).

Since

there's an epidemic of STDs among teens, nurses can play a vital role by educating teens, providing information about health care access, and encouraging teens to practice safer sex. Communication key factor. Listen first and remain nonjudgmental.

PRIMARY PREVENTION OF STD

Primary

prevention of STDs begins

changing the sexual behaviors that place persons at

with

risk for infection.

Health-care

providers have a unique opportunity to provide education and counseling to their patients

NURSING ASSESSMENT

Consists of:
1. 2. 3. 4. 5. 6. 7.

General Health Assessment and Examination Sexual History, Preferences, and Practices Previous History of STIs Specific Complaints (60% to 80% of STIs are asymptomatic) Genital Hygienic Practices (douching) Contraceptive History Infection Barriers Used

NURSING ASSESSMENT
A

holistic approach also assesses

Lifestyle Nutrition Stress

High-risk

clients should be screened for STIs regardless of whether manifestations are present at the time of a visit to a health care provider.

NURSING ASSESSMENT
Requirements:

Variety

of sexual activities Their effect on transmission of STIs Common manifestations for which to assess
A

prejudiced health professional cannot provide comprehensive care. An accepting attitude may ensure treatment and prevent disease transmission.

Effective

interviewing and counseling skills, characterized by respect, compassion, and a nonjudgmental attitude toward
all patients, are essential to obtaining a thorough sexual

history and to delivering prevention messages effectively.

TRUE OR FALSE?
Research

shows that health care professionals are unskilled and uncomfortable taking a clients sexual history, which can lead to underscreening.

TRUE OR FALSE?
Research

shows that health care professionals are unskilled and uncomfortable taking a clients sexual history, which can lead to underscreening.

Ans.

TRUE!

Health

professionals must be comfortable asking clients about sexual activity and must provide information in a way that does not turn off the clients or cause

embarrassment.

Instead of asking

Are you faithful?

Better say

How many sexual partners have you had?

Instead of using the term

Homosexual

Better say

Do you have sex

with men, women, or both?

Refrain from labeling clients as

Sexually Active

KEY COMMUNICATION TECHNIQUES

1)

Open-ended questions

Tell

me about any new sex partners youve had since your last visit Whats your experience with using condoms been like?

KEY COMMUNICATION TECHNIQUES

2) Understandable

language

Have

you ever had a sore or scab on your penis?

KEY COMMUNICATION TECHNIQUES

3) Normalizing

language

Some

of my patients have difficulty using a condom with every sex act. How is it for you?

THE FIVE Ps APPROACH

Partners Prevention

of Pregnancy Protection from STIs Practices Past History of STDs

PARTNERS
Do

you have sex with men, women, or both? In the past 2 months, how many partners have you had sex with? In the past 12 months, how many partners have you had sex with? Is it possible that any of your sex partners in the past 12 months had sex with someone else while they were still in a sexual relationship with you?

PREVENTION OF PREGNANCY
What

are you doing to prevent pregnancy?

PROTECTION FROM STIs

What

do you do to protect yourself from STDs and HIV?

PRACTICES
To understand your risks for STDs, I need to understand the kind of sex you have had recently. Have you had vaginal sex, meaning penis in vagina sex? If yes, Do you use condoms: never, sometimes, or always? Have you had anal sex, meaning penis in rectum/anus sex? If yes, Do you use condoms: never, sometimes, or always? Have you had oral sex, meaning mouth on penis/vagina? For condom answers: If never: Why dont you use condoms? If sometimes: In what situations (or with whom) do you not use condoms?

PAST HISTORY OF STIs

Have

you ever had an STI? Have any of your partners had an STI?

Additional

questions to identify HIV and viral hepatitis risk include: Have you or any of your partners ever injected drugs? Have any of your partners exchanged money or drugs for sex? Is there anything else about your sexual practices that I need to know about?

NURSING DIAGNOSES
Ineffective Anxiety Risk

Health Maintenance

for Situational Low Selfesteem Altered Comfort: Acute Pain Impaired Tissue Integrity Risk for Therapeutic Regimen Managment

Ineffective Health Maintenance

Ineffective Health Maintenance related to lack of understanding of the causes, treatments, and prevention of STIs as evidenced by practice of unprotected sex with an infected samesex partner Goal: The client will understand the cause, treatment, and prevention of specific STI as evidenced by successful treatment of STI secondary to change in sexual practices
Dx:

INTERVENTIONS
1. 2.

Teach about STIs Name, nature, and seriousness of the condition Mode of Transmission

Any sexual activity can spread STIs, not just intercourse High-risk activities include sexual relations with new or multiple partners

INTERVENTIONS
3.

Teach about STIs Actions the client should take to prevent spread of infections to others

Clients should always use a new latex condom for each sexual act Clients should finish all prescribed medications Sexual partners should be evaluated and treated if needed Clients should refrain from sexual relations until both partners have been treated Clients should refrain from sexual relations if either partner has any manifestations of an STI

INTERVENTIONS
4. 5. 6. 7. 8. 9. 10. 11.

Teach about STIs Incubation Periods Manifestation of Infection Asymptomatic Problems When and how to seek treatment Treatment methods Follow up Care Consequences of not completing them Risks and consequences of recurrent infections

INTERVENTIONS

Teach Condom Use

When used consistently and correctly, male latex condoms are highly effective in preventing the sexual transmission of HIV infection. Moreover, studies show condoms can reduce the risk for other STDs, including chlamydia, gonorrhea, and trichomoniasis; by limiting lower genital tract infections, condoms also might reduce the risk for women developing pelvic inflammatory disease (PID)

TRUE OR FALSE
Not

putting the condom on too tight at the end, and leaving 1.5cm (3/4inch) room at the tip for ejaculation. Putting the condom on snug can and often does lead to failure. Wearing a condom too loose can defeat the barrier. Avoiding inverting, spilling a condom once worn, whether it has ejaculate in it or not, even for a second.

TRUE OR FALSE
Avoiding condoms made of substances other than latex or polyurethane, as they do not protect against HIV. Use only water-based lubricants (e.g., K-Y Jelly, Astroglide, AquaLube, and glycerin) with latex condoms. Oil-based lubricants (e.g., petroleum jelly, shortening, mineral oil, massage oils, body lotions, and cooking oil) can weaken latex and should not be used. Using flavored condoms for oral sex only, as the sugar in the flavoring can lead to yeast infections if used to penetrate

TRUE OR FALSE
Use

a new condom with each sex act (i.e., oral, vaginal, and anal). Carefully handle the condom to avoid damaging it with fingernails, teeth, or other sharp objects. Put the condom on before the penis is erect and after any genital, oral, or anal contact with the partner.

TRUE OR FALSE
Use

a new condom with each sex act (i.e., oral, vaginal, and anal). Carefully handle the condom to avoid damaging it with fingernails, teeth, or other sharp objects. Put the condom on after the penis is erect and before any genital, oral, or anal contact with the partner.

TRUE OR FALSE
Ensure

adequate lubrication during vaginal and anal sex, which might require the use of exogenous waterbased lubricants. To prevent the condom from slipping off, hold the condom firmly against the base of the penis during withdrawal, and withdraw while the penis is still erect.

BARRIERS TO CONDOM USE

Women

may not believe they are empowered to make healthy choices. Older people may not have experience with condoms. Condoms may not be acceptable to some clients for religious, cultural, or ethnic reasons.

INTERVENTIONS

Use Therapeutic Communication.

Requires sensitivity and skillful interaction Needs to be adept in interpersonal communication Offers encouragement, support and accurate information

EVALUATION
It

is expected that the STI will be successfully treated and, if possible, erradicated. The client will be able to state the cause, manuifestations, treatment, and prevention of STIs and will remain free of STIs.

FREQUENTLY ASKED QUESTIONS

(from DOH)

am a teenager or young adult, I'm not at risk for an

One

STI, right? Wrong.

out of every four teenagers and young adults will get an STI, even though many think they know how to protect themselves.

Who

are at risk for acquiring STIs? Although younger people have the highest rates for STDs, all age groups are at risk.

Who

are at risk for acquiring STIs? Anyone who engages in intimate physical contact can contract and transmit an STI.

Who

are at risk for acquiring STIs? The fetus or neonate can be infected across the placenta or during vaginal birth.

Who

are at risk for acquiring STIs? Infants and children can be infected through child abuse.

Who

are at risk for acquiring STIs?

Children

and adolescents are particularly vulnerable due to biologic variables and because they are more likely to have more frequent unprotected sex and shorter term relationships leading to multiple partners and they face obstacles in obtaining health care services.

Who

are at risk for acquiring STIs?

High-risk sexual activity Use of prostitutes Multiple or casual sexual partners Sex with IV drug users and infected people Unprotected sex Exchanging sex for money or drugs

Who

are at risk for acquiring STIs?

Intravenous

Inner city residents People with poor

users

(IV) drug

hygiene and/or poor nutrition

Why

It's not always because people don't know. Other reasons:

dont teenagers and young adults protect themselves if they are having sex?
embarrassed about buying or getting condoms, feel peer/date pressure use of alcohol and drugs causing poor decision-making have a lack of knowledge believe using birth control pills is enough protection embarrassed about asking questions don't think ahead of time

Can
This

you get an STI from a public restroom?

is not very likely.
Garapata, or pubic lice may be transmitted through sexual contact, sleeping in infected bedding, sharing infected clothing and possibly through sitting on an infested toilet seat. However, lice cannot survive away from the human body for longer than 24 hours. So contracting pubic lice from a toilet seat is possible, but it's unlikely.

Can
This

I get an STI from kissing?

is possible, but not very common. If your partner's mouth is infected with an STI, then he or she may be able to pass that infection to your mouth during a kiss. Kissing the infected area may lead to transmission of the infection.

Can

I get an STI from oral sex?

it is important to use barrier protection, like unlubricated condoms or latex dental dams to protect yourself during oral sex.

Yes!
Therefore,

What
Physical

are the common symptoms of STIs?

symptoms like bumps or sores on the skin, itchy discharge, pain or burning during urination, fever, or symptoms like the flu. But all of these symptoms can be caused by other illnesses that are not sexually transmitted. Some STIs do not cause any symptoms at all.

Can

Yes.
Many

and not

I have an STI

know it?

STIs can take weeks, months or years before symptoms show. Some people never develop symptoms for some STIs. STIs can still be passed to someone else even when a person is not experiencing symptoms.

What

do I do if I think I have an STI?

Seek

immediate medical help. Your health care provider is the best choice. The local community clinics would also be able to help you.

How
The

do I know if my partner is infected?

may not know your partner is infected unless he or she tells you.
because some STIs don't show any symptoms, your partner may not even know if he or she is infected. simple answer is that you

Remember,

How
There

do I get tested for STIs?

are many different tests for each of the different STIs. There is not one test that will screen for all STIs. Some STIs are hard to test for if you do not have any symptoms.

Where

go to get tested?
do I

Local

health department Emergency departments Community clinic Private doctor Family planning clinics

What

are the complications of STIs?

Pelvic

inflammatory disease Infertility Ectopic pregnancy Premature births Anogenital cancer

What

is the best type of protection during sexual activity?

A ABSTINENCE B BE FAITHFUL C CONDOM USE D DO IT YOURSELF

ABCD

the end!