Adapted from "Sexually Transmitted Diseases" module, Pre-Service Health Training for Volunteer Binder, Peace Corps Office of Medical Services

BACKGROUND

Advisers and students themselves have a critical role in the effort to prevent sexually transmitted disease (STDs). Many students have one or more sexual partners during their stay. Studies have shown that the transmission of information alone frequently does not result in reduced participation in high-risk behaviors. Even educated and informed individuals may need help to effectively translate their knowledge.

Students should understand the following:

1. These diseases are communicable, and prevention (from becoming infected and from infecting others) is a matter of personal responsibility.
2. Although recognition of symptoms and seeking medical attention when they are present are essential, it is most important to remember that STDs are frequently present with no symptoms.
3. The presence of a STD significantly increases the risk of acquiring HIV.

TRANSMISSION

There are two general categories of risk behavior for the transmission of sexually transmitted disease:

Intimate Sexual Contact

The risk spectrum of behavior which can lead to transmission of STD's by intimate sexual contact includes:

Safe

• Massage
• Hugging
• Body rubbing
• Kissing (dry)
• Masturbation
• Hand-to-genital touching or mutual masturbation

Possibly Safe

• Kissing (wet)
• Vaginal/rectal intercourse using latex condoms
• Oral sex on a man using a latex condom
• Oral sex on a woman who does not have her period or a vaginal infection with discharge (use a latex barrier such as a dental dam for extra safety)

Unsafe

• Any intercourse without a latex condom
• Oral sex on a man without a latex condom
• Oral sex on a woman during her period or vaginal infection with discharge without a latex barrier such as a dental dam
• Semen in the mouth
• Oral-anal contact
• Sharing sex toys or douching equipment
• Blood contact of any kind, including menstrual blood, sharing needles, and any sex that causes damage and/or bleeding

Parenteral Transmission

Dirty needles and blood transmission of STD microbes present in blood of infected persons can be prevented by avoiding unsterile needles and unscreened blood products. Other mechanisms of transmission include tattooing and contaminated instruments used in traditional ceremonies.

GENERAL SYMPTOMS OF STDs

Any of the following symptoms may indicate a sexually transmitted disease and should prompt medical evaluation:

• Discharge from the penis or change in vaginal discharge
• Itching or burning in the genital area
• Redness or swelling in the genital area
• Sores, blisters or rash in the genital area
• Pain or tenderness in the abdomen, pelvic area or genital area
• Urinary tract symptoms such as burning on urination or urinary frequency

SPECIFIC DISEASES

Sexually transmitted diseases are infections caused by microbes -bacteria, viruses, and protozoa.

Bacterial STDs include:

• Chlamydia
• Gonorrhea
• Syphilis
• Chancroid
• Lymphogranuloma venereum

Viral STDs include:

• Herpes simplex
• HIV
• Human papilloma virus (HPV)
• Hepatitis B

Protozoal STDs include:

• Trihomoniasis

Ectoparasites such as scabies and lice, through not microbes, are frequently spread by sexual contact.

DIAGNOSIS

Physical examination and lab tests are needed to help detect symptomatic and asymptomatic STD's.

• Findings on physical exam
• Direct examination of specimens and cultures.
• Blood tests

TREATMENT

• Antibiotics can cure STDs caused by bacteria (chlamydia, gonorrehea, syphilis). Immunity, however, is not acquired and reinfection can occur.
• Although manifestations of some viral STDs can be treated, the infection cannot be cured. These are lifetime infections.
• Partner notification and treatment, where applicable, are essential. Policies and procedures regarding confidentiality are important in this process.
• Blood tests for HIV and syphilis are indicated when an STD is diagnosed.

Adapted from "Sexually Transmitted Diseases" module, Pre-Service Health Training for Volunteer Binder, Peace Corps Office of Medical Services