Sexually Transmitted Infections (STIs) Risk Factors

Study Notes

Pelvic Inflammatory Disease (PID)

Risk factors: females 15-25 years old, history of chlamydia or gonorrhea, multiple partners, a partner with an STI, unprotected intercourse
Symptoms: fever, chills, cervical motion tenderness, WBC on vaginal microscopy
Assessment: laboratory examination for gonorrhea, chlamydia, and vaginal microscopy of vaginal discharge, pregnancy test, and serum analysis for HIV and syphilis
Treatment: inpatient or outpatient management dependent on patient's ability to follow outpatient regimen; pregnant patients should always be treated inpatient; outpatient treatment involves 2-3 antibiotics, including ceftriaxone, doxycycline, and flagyl; inpatient treatment involves IV antibiotics, often cefoxitin and clindamycin

Trichomoniasis

Definition: a sexually transmitted parasite, most common non-viral STI
Risk factors: unprotected intercourse
Symptoms: copious frothy, yellow vaginal discharge, fishy vaginal odor, vulvar irritation
Treatment: metronidazole 500 mg 1 po bid x 7d, no ETOH

Chlamydia

Definition: most common STI, fast spreading, often asymptomatic
Risk factors: past chlamydia infections, increase risk of ectopic pregnancies and tubal factor infertility
Symptoms: mucopurulent discharge from the cervical os, friable, edema in the area of ectopy
Screening and diagnosis: cervical cultures, urine culture, CDC recommendations for screening; gold standard diagnosis: nucleic acid amplification test (NAAT)
Treatment: doxycycline 100 mg po bid x 7 days or azithromycin 1 gm po x 1; sexual partners should also be treated; retesting should be done 3 months after treatment

Gonorrhea

Symptoms: purulent vagina.d/c, dysuria, cervical motion tenderness; 80% of females are asymptomatic in early stages
Diagnosis: direct culture from urethra, endocervix, throat, rectum; NAAT test is the most sensitive for detection
Treatment: ceftriaxone 500 mg IM once (1 gram IM once if > 300 pounds); sexual partners should also be treated; retesting should be done 3 months after treatment

Syphilis

Definition: earliest described STI, highly communicable and rates have been rising since 2000
HPV vaccine: protects against anal and oropharyngeal cancers; 3 injections (baseline, 2 mos, 6 mos); ages 9-45; given IM (0.5 ml, recommended in deltoid)

HIV

Definition: human immunodeficiency virus, attacks the body's immune system; if not treated, can lead to AIDS (acquired immunodeficiency syndrome)
Risk factors: heterosexual transmission, women are the fastest-growing population of individuals with HIV, transmission occurs through exchange of body fluids
Symptoms: seroconversion occurs within 6-12 weeks, usually without symptoms, may have flu-like symptoms, fever, HA, night sweats, nausea, diarrhea, weight loss, sore throat, and rash
Treatment options: HIV treatment (antiretroviral therapy or ART) involves taking medicine as prescribed by a health care provider; pre-exposure prophylaxis (PrEP) involves taking antiretrovirals to prevent replication of the virus and infection; daily adherence to tenofovir/emtricitabine (Truvada); follow-up care: HIV AB test q 3 m, STI testing q 6 m.

Description

Identify the risk factors associated with Sexually Transmitted Infections (STIs) in individuals, particularly females aged 15-25, and understand the importance of assessment and treatment. This quiz covers the symptoms, assessment, and treatment of STIs.