Sexually transmitted infections (STIs)
What are sexually transmitted infections (STIs)?
More than 16 infectious diseases are recognized as being sexually-transmitted infections. The STIs described in these guidelines cover only those most common (i.e., situations with which school nurses and child care personnel are more likely to be confronted). Teens have very high reported rates of STIs for several reasons:
- Many STIs do not cause symptoms.
- Sexual partners do not know that they are infected and can spread the disease.
- Social stigma attached to STIs may cause embarrassment and result in hesitance to be examined for fear that others will “find out” about the infection.
- There is a lack of public knowledge about STIs and how they are transmitted.
Signs and symptoms
Signs and symptoms vary depending on the disease. See the disease-specific chapters in these guidelines.
Incubation period
The incubation period varies depending on the disease. See the disease-specific chapters in these guidelines.
Contagious period and spread
- STIs are transmitted through various forms of sexual contact: oral, anal, and vaginal. People with an STI are generally contagious until they receive treatment, although some STIs are potentially communicable for life (like HIV, genital herpes, and genital warts).
- The contagious period and spread varies depending on the disease. See the disease-specific chapters in these guidelines.
Public health reporting requirements
- Chlamydia, gonorrhea, and Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) must be reported to the state or local public health agency within four days of diagnosis.
- Syphilis must be reported within one work day of a suspected or confirmed diagnosis.
- The possibility of sexual abuse must be considered when infections occur in prepubescent children and must be reported to appropriate authorities.
Control of spread
- People with infection should be examined by a health care provider and treated (if treatment is available) as soon as the diagnosis is confirmed to prevent complications. Treatment of partner(s) is a crucial strategy to prevent re-infection. People with infection should seek medical care if symptoms persist or recur. Parental/guardian consent is not required for minors to be examined and treated.
- People with infection should avoid sexual activity until they and their partner(s) are treated (if treatment is available) and cured.
- People with infection should abstain from sex or use condoms to prevent future infections.
- General education on STI prevention is advocated.
- A vaccine exists for the most common types of Human Papillomavirus (HPV) (the virus that causes genital warts, cervical and other types of cancer) and Hepatitis B. There are currently no other vaccines for STIs.
Treatment
People with infection should be taught how to take prescribed medications correctly.
Exclusion
No exclusions or environmental interventions are necessary. STIs require close intimate physical contact for transmission, virtually always of a sexual nature.
Role of teachers, caregivers, and family
- General education about sexual health and STI prevention is recommended.
- Infections in prepubescent children and other high-risk individuals must be reported to appropriate authorities to address the possibility of sexual abuse.