Sexually Transmitted Infections

Sexually Transmitted Infections

Sexually Transmitted Infections (STIs), also known as sexually transmitted diseases (STDs), may be bacterial, viral, or parasitic in nature; they are highly contagious and are transmitted via skin-to-skin contact or the exchange of bodily fluids (i.e., semen, blood, urine, saliva, etc). True to their name, STIs are frequently transferred through sexual contact, including oral, vaginal, and anal, but may also be passed from mother to child via vaginal birth and even by sharing needles. There are multiple STIs the Medical Assistant should be aware of, including chlamydia, genital herpes, genital warts, gonorrhea (the clap), hepatitis B, herpes simplex virus (HSV-1 and HSV-2), HIV/AIDS, human papillomavirus (HPV), pubic lice (crabs), syphilis, and trichomoniasis (trick).

Various factors place a patient at an increased risk for STIs. However, there are ways to combat each risk factor. Unprotected sex and sexual contact with multiple partners are two of the more common risk factors for spreading STIs.² Using protection like a condom (male or female) or a dental dam for oral sex and limiting partners or being acutely aware of their STI status will help limit the spread through sexual contact.³

Sharing needles (including those in a tattoo gun, piercing needles, or needles used for intravenous drugs) is another way to spread an STI, amongst other bloodborne pathogens, easily. Though needles are not sexual, blood is shared, and therefore, diseases may be spread.¹ To prevent the spread of disease, it is crucial always to use sterile equipment.

Another risk factor is if the patient has a history of an STI. In this case, it is very common for them to get another. Again, information regarding your partners’ STI status and the implementation of barrier devices are the best ways to prevent the accrual of further STIs.

Alcohol and drug use can also put an individual at increased risk of acquiring an STI. This results from impaired judgment and the increased likelihood of engaging in “risky” behaviors.² Additionally, those between the ages of 15 and 24 are at a higher risk of STIs as their bodies are more biologically prone to acquiring an infection, and they are less likely to get recommended STI tests.⁴ It is crucial to talk with your provider and complete the recommended STI tests to limit their spread. 

Sometimes, a patient will not have any signs or symptoms of an STI, which is why testing is imperative; however, the patient will often present with bumps, sores, or warts on or near the genitalia, severe itching, and/or swelling around the genitalia. In these cases, testing and examination are crucial. Patients experiencing an STI may also have pain with urination or sexual intercourse, and men may present with white, yellow, or green penile discharge.^1,4 Finally, patients may present with whole-body symptoms like fevers, rashes, unexplained weight loss, diarrhea, and jaundice.¹ 

If there are signs or symptoms of STIs, the patient should be seen by a physician immediately to receive treatment. This limits the severity of the illness and the likelihood of it spreading. To properly diagnose an STI, the physician will consider the patient's whole medical and sexual history as well as any symptoms they are experiencing. There are multiple ways a provider can test the patient for an STI. The first is through blood tests; the STIs that can be tested through blood include genital herpes, HIV, syphilis, and hepatitis B.⁵ Another way to test for an STI is through swabs. Swabs can be vaginal, oral, rectal, or through lesions and discharge. STIs that can be tested by a swab are HPV, chlamydia, gonorrhea, and herpes.⁶ Lastly, STIs can be tested through urine; those STIs are chlamydia and gonorrhea.⁷

Immediate treatment for STIs can save patients from serious illnesses and discomfort. Not all STIs are curable, but they can be treated and managed. There are treatment options, including antibiotics or antivirals; antibiotics may be given orally or via an injection in the buttocks. Antivirals can be used for viral infections that come and go, like herpes, which is recurrent. Prevention is key with STIs. As previously mentioned, while some are curable, others require lifelong treatment, which can range from highly inconvenient to debilitating for the patient. A Medical Assistant needs to be able to help support the patient through the hard times and encourage patients to do yearly testing and exams. 

 

References:

1. Cleveland Clinic (2023, February 3). Sexually Transmitted Infections. Retrieved December 9, 2023, from https://my.clevelandclinic.org/health/diseases/9138-sexually-transmitted-diseases--infections-stds--stis
2. Mayo Foundation for Medical Education and Research (MFMER) (2023, September 8). Sexually transmitted diseases (STDs). Mayo Clinic. Retrieved December 9, 2023, from https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240
3. National Library of Medicine (2015, August 6). Associated Risk Factors of STIs and Multiple Sexual Relationships among Youths in Malawi. NIH. Retrieved December 9, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527764/
4. Raw & Design By Day (2021, September 22). Is Male Discharge Normal? Your Sexual Health. Retrieved December 10, 2023, from https://yoursexualhealth.co.uk/blog/is-male-discharge-normal
5. Dotdash Media, Inc (2023, May 7). What STIs Can Be Detected by Blood Tests? Very Well Health. Retrieved December 10, 2023, from https://www.verywellhealth.com/can-i-get-an-std-blood-test-3132740
6. National Library of Medicine (2021, September 21). STD Tests. Medline Plus. Retrieved December 10, 2023, from https://medlineplus.gov/lab-tests/std-tests/
7. Mayo Foundation for Medical Education and Research (MFMER) (2023, April 14). STD testing: What's right for you? Mayo Clinic. Retrieved December 10, 2023, from https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/in-depth/std-testing/art-20046019