Sexually Transmitted Infection

Sexually Transmitted Infection

• Sexually transmitted infection is an infection that is usually transferred or spread by sexual contact, particularly vaginal contact, anal sex, and oral sex. It is transmitted via intercourse by the infected person to his or her partners.
• Sexually transmitted illnesses and venereal diseases are other names for it.
• Bacteria, parasites, and viruses are responsible for STDs.

Risk factors for STDs

The following are risk factors for sexually transmitted diseases:

1. Host factors

• Age- Half of all STDs arise in persons between the ages of 15 and 25. During the neonatal and fetal development periods, morbidity is more significant and hazardous.
• Sex- Young women are more susceptible to STDs than men due to:
  • Women have a higher mucosal exposure to STDs than males.
  • Women traditionally have sex with older males, who have more sex, many sex partners, and are more likely to have STDs.
  • Socioeconomic women have no sex decision-making rights and cannot require their partners to wear contraceptives.
  • Medically, most women hide their sexually transmitted illnesses due to shyness, and the majority of doctors are men.

2. Marital status- STDs are more common among single, divorced, and separated people than in married couples.

3. Environmental factors

• Socio- economic status – Women with poor socioeconomic standing are forced to become prostitutes in order to survive, and males who travel for work have sexual relationships with STD sex workers. They have fewer access to health care and education.
• Demographic factors- Young individuals are particularly prone to STDs.

4. Social factors

• Prostitution- The major source of STD transmission is prostitution. It's a manifestation of poverty.
• Broken homes- Women from socially dysfunctional homes are typically lured to prostitution. Family members from broken households are frequently dissatisfied, and kid raising is not good.
• Sexual disharmony- STDs are frequently spread to separated and divorced persons.
• Emotional immaturity- This has been emphasized in the acquisition of STIs.
• Urbanization and industrialization- These are favourable to the kinds of lifestyles that lead to a high degree of infection as a result of long hours of work, isolation from family and relatives, and social mobility that fosters a sexual connection.
• Social disruption- Civil conflicts and catastrophic calamities have also increased the likelihood of STD spread.
• International travels- It also aids in the import and export of STDs such as gonorrhea.
• Changing behaviors patterns- More freedom and modernisation, as well as early acceptance of sexual relationships, all enhance the likelihood of STD transmission.
• The social stigma
• Alcoholism
• Terrorism as well as conflicts

Mode of transmission

• STDs are spread through contact with the following:

1. Penis
2. Vagina
3. Rectum
4. Breaks in skin
5. Mucous Membranes

• And also due to:

1. Needle Sharing
2. Blood Contact
3. Vertical transmission( Mother-to-child)

Sexually transmitting agents/ pathogens

Pathogen- Bacteria Agents

• Neisseria Gonorrhoea – gonorrhea, urethritis, cervicitis, epididymitis
• Chlamydia tracomatis- Chlamydia infection, cervicitis,
• Treponema pallidum- syphilis
• Haemophilus ducreyi- Chancroid
• Klebsiella granulomatosis( also called calymmatobacterium granulomatis)- granuloma inguinale or donovanosis

Pathogens –Viral Agents

• Herpes simplex virus type 2- genital herpes
• Hepatitis B virus- acute and chronic hepatitis, chronic hepatitis leads to liver cancer.
• Human Papilloma Virus- genital warts, sometimes certain subtypes leads to cervical cancer in female
• Cytomegalovirus- inflammation of organs like brain, eye, and bowel
• HIV- AIDS

Pathogens- Fungal Agents

• Candida Albicans- Vaginitis

Pathogens- Protozoal Agents

• Trichomonas Vaginalis- Vaginitis
• Candida albicas- Vulvovaginitis, inflammation of glans penis and foreskin in men

Sexually transmitted diseases may cause the following:

• Acute morbidity in adults, particularly males
• Complications, particularly in women, include upper genital tract infections, such as salpingitis, and pelvic inflammatory disorders.
• Infertility
• Ectopic conception
• Premature demise
• Neonatal mortality rate
• Unfavorable pregnancy result
  1. abortion
  2. stillbirth
  3. pre-maturity
  4. birth defects
  5. low birth weight

• Mortality and morbidity among newborns
  1. Ophthalmic neonatrum
  2. Pneumonia, otitis, encephalitis, sepsis
  3. Congenital syphilis

Signs and Symptoms of Sexually Transmitted Infection

The symptoms vary depending on the kind of STI, however some frequent ones are:

• Discharge from the penis or vaginal area that is unusual
• Warts or sores in the vaginal region
• Urination causes a burning feeling
• Itching and burning in the vaginal region
• Itching, pain, and bleeding 
• Lower abdominal pain 
• Pain during sex
• Fever
• Vaginal discharge that smells unusual or strange
• Vaginal bleeding that is unusual
• Groin swelling

Prevention of Sexually Transmitted Diseases

There are certain objectives for prevention of STDs which are as follows:

1. Stoppage of sexually transmitted infection
2. Keeping sickness and complications at bay
3. Lowering the risk of HIV infection

There are certain strategies for the prevention of the STDs they are:

• Behavioral changes
  • The use of condoms
  • Sex with only one partner.
  • Multiple partners should be avoided.
  • People and communities must be safeguarded against commercial sex workers.
• Communication
  • The topic of sex education must be incorporated in school and college curricula.
  • There must be widespread dissemination and mass or group education on sex education.

• Harm reduction
  • Correct teaching and counseling on the proper use of contraceptive devices should be provided.
  • Condoms should be available and easily accessible to the general public.
  • STD testing should be done on both partners.
  • Early infection detection, prevention, and treatment
  • Every location should perform a survey in high-risk categories for case detection.
  • Mother-to-child transmission prevention
  • Using care when touching an infected person's needle
  • Disposal of diseased human fluids and other used items ( stool, sputum, blood)

Screening for STIs

• Education and counseling:
  • Using a condom
  • Single-partner safe sex
  • Antenatal care can help you prevent HIV/AIDS and protect the unborn child.

• Family planning considerations of STIs
  • IUDs should be removed by women since they increase the risk of pelvic inflammatory disorders.
  • condom use during sexual activity
  • Women who have STIs need to use IUDs as long as the infection is not completely cured.

REFERENCES

Ambika Rai, Kabita Dahal. Community Health Nursing II. Kathmandu: Makalu Publication House, 2012 (reprint).
Dr.Suwal S.N. & Tuitui R. (2063) A Textbook of Community Health Nursing, 1st edition, Vidyarthi Prakashan (P). Ltd. Kamalpokhari, Kathmandu
Mandal, G.N. Textbook of Adult Nursing. Kathmandu: Makalu Publication House, 2013.
National Guidelines Prevention of Mother to Child Transmission of HIV in Nepal- Government of Nepal Ministry of Health and Population National Center for AIDS and STI Control, Kathmandu Nepal, April 2008
WHO Antiretroviral Drugs for Treating Pregnant Women and Preventing HIV infection in infants: Toward Universe Access: Recommendations for a Public Health Approach (2006)