HANDOUT 1.4.

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Common Sexually Transmitted Infections (STIs)

Sexually Transmitted Infections (STIs) are usually spread from an infected person to a
partner during sexual intercourse. While some are spread only through sexual intercourse,
others can be spread in other ways. These infections mainly affect the reproductive organs,
and with the culture of silence on reproductive matters STIs can be difficult to talk about.

Some common infections are:

Gonorrhoea; Chancroid; Syphilis;
Genital Herpes; Genital Warts; HIV;
Trichomonas Vaginalis; Thrush/Candidiasis; Pubic Lice

Signs and Symptoms: Any abnormality in the genital area should be treated. Most signs
are easily noticed in men due to the position of their organs, but signs may be absent or
difficult to detect in women.

Major signs include:

 Ulcers, sores, bruises, wounds or rash on the genitalia.
 Discharge from the vagina or penis (women have a normal discharge from the vagina
which is colourless, odourless, non-itchy and not heavy. Any deviation should be
investigated).
 Pain in urinating.
 Pain in the reproductive organs.
 Growth on or around the reproductive organs.
 Lower abdominal pain.
 Lower backache.

Treatment Compliance: If those with STIs seek treatment early, most STIs can be treated
and cured. Delaying makes the infection more difficult to treat and allows time for infecting
partners. Be open with the health care provider, as misinformation can result in your getting
the wrong treatment. Finish all the medication even when signs and symptoms disappear.
Use condoms with all sexual partners until you are completely cured. Advise all sexual
partners to seek treatment. Go for review even if you feel very well.

Prevention: All STIs are preventable, and it is your duty to protect yourself and the ones you
love.
 Abstain from sexual intercourse.
 Stick to one uninfected, mutually faithful partner.

Condoms for males or females greatly reduce the risk of getting STIs if they are used
correctly and consistently.

REMEMBER!
Some STIs are curable, but all STIs are preventable.

Preventing the spread of sexually transmitted infections is everyone’s responsibility.

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HIV and AIDS

AIDS means Acquired Immuno Deficiency Syndrome. It is a condition where the power in the body to
fight against infection (immunity) is weakened. The germ (virus) which causes AIDS is called HIV
(Human Immunodeficiency Virus). AIDS has no cure.

Window Period: It can take 3 months or longer for the AIDS virus to be detected in a person. During
this period an infected person can infect any sexual partners before realizing that he or she has the
HIV. The virus will continue to attack the body’s disease-fighting power. It can take 5 to 10 years for a
person to develop symptoms of AIDS. During this period the infected person looks completely healthy
but is continuously infectious.

Modes of Transmission of HIV

Through sexual intercourse with an infected person.
Through a blood transfusion from infected blood. However in Zimbabwe blood is screened for HIV.
From infected mother to her child during pregnancy, labour and delivery and breast feeding.
By use of infected and not properly cleaned needles, razor blades and other skin-piercing
instruments.

What happens when a person has developed AIDS

HIV has no obvious signs or symptoms.
Weight loss.
Chronic diarrhoea.
Fever for long durations
Hair becomes thin, scanty and shiny.
May get TB which is difficult to cure.
Skin diseases and rashes.
Other opportunistic infections.

Prevention: The spread of HIV infection can be prevented by:

Abstaining from sex.
Having one mutually faithful uninfected partner.
Correct and consistent use of condoms all the time during sexual intercourse
Avoiding the use of or sharing of unsterilized needles and syringes.
Avoiding sharing razor blades and ear-piercing instruments that cut the skin.

The HIV virus CANNOT be spread through kissing and hugging; sharing cutlery; sharing the same
toilet and baths; sitting together; working together; living in the same house; shaking hands; talking,
sneezing or coughing nor mosquito and other insect bites. However, persons caring for people living
with HIV at home need information to protect themselves.

THE RELATIONSHIPS BETWEEN STIs AND HIV: Concentrating on the prevention and treatment of
STIs, rather than just focusing on HIV infection and AIDS, has a number of advantages:
Infection with other STIs, in particular those that cause sores in or around the sexual parts, makes
it easier for a person to get HIV.
HIV affects the response to treatment of STIs (making them difficult to treat and slow to heal).

HIV changes the signs of some STIs making it difficult to identify them. Controlling the spread of HIV
infection is linked to preventing and controlling STIs.

HIV TESTING AND COUNSELING (HTC)

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An HIV prevention intervention normally initiated by the client and entered by the client’s free will. It is
the opportunity for the client to confidentially expose and understand his or her HIV risks and to learn
his or her HIV status. HTC helps clients to make informed decisions.
Indications of HTC
Anyone who wants to know their HIV status.
Anyone with a chronic condition not responding to Post Test Counselling
Anyone with repeated infections.
Those referred by their doctors or relatives.
As a requirement for insurance or employment.
Compulsory for sexual offenders.
Following accidental needle prick for health providers, etc.

PMTCT: HIV can be passed on from an infected mother to her child before birth, during delivery or
while breastfeeding. Prevention of mother to child transmission of HIV (PMTCT) is an intervention
aimed at reducing the risk of baby/child getting the infection form the mother.
In all the provinces in Zimbabwe, there are some hospitals and clinics offering PMTCT services to
pregnant women on a voluntary basis. To reduce the chances of men resisting PMTCT, social
mobilisation campaigns have been launched leading to the intervention being renamed - prevention
of parent to child transmission of HIV (PPTCT)

Opportunistic Infections/Conditions
Tuberculosis; Gullian Bar’s Syndrome; Diarrhoea;
Herpes Zoster; Karposi Sarcoma; Cryptococcal Meningitis.
Pneumonias including PCP; Thrush;

Creating a Referral Network

The client should be informed about other services in the community which offer further
counselling.
If the client is positive, should be referred to AIDS support groups for further counselling and
support.
Trainers to be knowledgeable on AIDS policy and home based care policy and discharge policy.

Accepting and Coping with HIV Status

Support – should come from family, social groups, fellowshipping, peer – HIV Positive
Living positively – clients should get adequate nutrition, clean water, counselling to reduce stress.
Risk education – clients should be educated on behaviour change, disclosure of status, HTC, use
of condoms.
Create awareness on the programme.
Counsel pregnant mothers on HTC to help them have options of breastfeeding.
Creating awareness on availability of anti-retroviral drugs and their significance on the prevention
of parent to child transmission of HIV/AIDS.
Promotion of safe motherhood i.e. pregnant youths to attend antenatal care at health institutions.

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Adolescents Living with HIV

Special challenges in providing Prevention, Treatment, Care and Support for Adolescents living with HIV
Challenges Adolescents who acquired Adolescents who acquired HIV
HIV perinatally during adolescence
Beneficial disclosure • If not yet discussed, • Need support to tell chosen
disclosure to adolescent family members and friends
• Peers • Will benefit from others knowing
so they can get support
• Fear of stigma/blame
Positive prevention • Not yet sexually active • Already sexually active
• Preparing for sexual • Changes in health risk
activity behaviour(s)
• Wanting sexual relations • Wanting marriage and children
and pregnancy in the • Need life skills, peer support
future
Consent & • Living with family/guardian • Legal position on age of
confidentiality • No longer a compliant consent
child • Concern about confidentiality
• Needs to start taking • Desire for independence and
responsibility for own need for support
treatment
Transition of care • Paediatric to adolescent • Adolescent to adult

ART and adherence • Choice of regimens • When to begin ART

• Adherence: no longer a • Choice of regimen
child • Adherence
Antiretroviral therapy • Yes • Probably not yet needed
• Adherence may be a • When taking ARVs: adherence
problem as an adolescent, may be a problem
not as a child