{
  "name": "Sexually Transmitted Infections",
  "slug": "sexually-transmitted-infections",
  "url": "https://nursingplex.com/care-plans/sexually-transmitted-infections",
  "category": "Reproductive & Genitourinary",
  "summary": "Screening, treatment, partner notification and prevention counseling.",
  "nursing_diagnoses": [
    "Risk for infection transmission",
    "Deficient knowledge",
    "Situational low self-esteem"
  ],
  "overview": [
    "Sexually transmitted infections (STIs) encompass a diverse group of bacterial (chlamydia, gonorrhea, syphilis), viral (HIV, HSV, HPV, hepatitis B), and parasitic (trichomoniasis) infections transmitted through sexual contact. Many STIs are asymptomatic or produce mild, nonspecific symptoms, allowing silent transmission and delayed diagnosis, which is why routine screening in sexually active individuals — particularly those under 25, with new or multiple partners, or in higher-prevalence populations — is a cornerstone of public health prevention.",
    "Untreated STIs carry serious long-term consequences: chlamydia and gonorrhea can cause pelvic inflammatory disease and infertility in women and epididymitis in men; untreated syphilis progresses through primary, secondary, latent, and tertiary stages that can involve the cardiovascular and central nervous systems; HPV is linked to cervical, anal, and oropharyngeal cancers; and HIV progressively destroys the immune system without antiretroviral treatment. Congenital transmission during pregnancy can cause serious harm to the fetus/newborn, making prenatal screening essential.",
    "Nursing care combines nonjudgmental, confidential assessment and counseling, accurate testing and treatment per current guidelines, partner notification and treatment support, and comprehensive prevention education, recognizing that stigma remains one of the largest barriers to testing, treatment adherence, and honest communication about sexual health."
  ],
  "key_facts": [
    {
      "label": "Screening recommendation",
      "text": "Annual chlamydia/gonorrhea screening is recommended for sexually active women under 25 and older women with risk factors; HIV screening at least once for all adults 13-64."
    },
    {
      "label": "Curable vs. manageable",
      "text": "Chlamydia, gonorrhea, syphilis, and trichomoniasis are curable with appropriate antibiotics; HIV, HSV, and HPV are manageable but not curable."
    },
    {
      "label": "Partner treatment",
      "text": "Expedited partner therapy allows treatment of sex partners without an exam, reducing reinfection rates for chlamydia and gonorrhea."
    },
    {
      "label": "HPV vaccination",
      "text": "The HPV vaccine prevents infection with the strains responsible for most cervical and other HPV-related cancers, ideally given before sexual debut."
    },
    {
      "label": "PrEP",
      "text": "Pre-exposure prophylaxis significantly reduces HIV acquisition risk in high-risk individuals when taken consistently."
    }
  ],
  "nursing_priorities": [
    "Provide nonjudgmental, confidential sexual health assessment and counseling.",
    "Facilitate accurate testing and prompt treatment per current guidelines.",
    "Support partner notification and treatment to prevent reinfection.",
    "Educate on consistent condom use and other prevention strategies.",
    "Screen for and address co-occurring STIs, since one increases risk of others.",
    "Support medication adherence for chronic viral STIs (HIV, HSV).",
    "Address the psychosocial and relationship impact of an STI diagnosis."
  ],
  "assessment": {
    "subjective": [
      "Reports of unusual genital discharge, odor, or itching",
      "Complaints of dysuria, pelvic pain, or pain with intercourse",
      "Reports of genital sores, bumps, or lesions",
      "Concerns or anxiety about a new diagnosis or partner notification",
      "History of unprotected sex, multiple partners, or partner with known STI",
      "Reports of sore throat or rectal symptoms related to specific exposure sites"
    ],
    "objective": [
      "Abnormal genital, cervical, or urethral discharge on exam",
      "Genital ulcers, warts, or vesicular lesions",
      "Lymphadenopathy, particularly inguinal",
      "Positive laboratory results (NAAT for chlamydia/gonorrhea, RPR/treponemal test for syphilis, HIV antigen/antibody test)",
      "Signs of pelvic inflammatory disease: cervical motion tenderness, adnexal tenderness, fever",
      "Rash consistent with secondary syphilis (palms/soles) if present",
      "Signs of advanced HIV disease if diagnosis is delayed (opportunistic infection, wasting)"
    ],
    "related_factors": [
      "Unprotected sexual contact with an infected partner",
      "Multiple sexual partners or a partner with multiple partners",
      "Inconsistent or incorrect condom use",
      "Substance use impairing judgment regarding safer sex practices",
      "Lack of access to healthcare, testing, or comprehensive sexual health education",
      "Stigma or fear discouraging testing and open communication with partners",
      "Vertical transmission risk during pregnancy/delivery for untreated maternal infection"
    ]
  },
  "goals": [
    "The client will complete testing and receive appropriate treatment for diagnosed STIs.",
    "The client will demonstrate understanding of the infection, its transmission, and treatment plan.",
    "The client will notify and support treatment of sexual partner(s), directly or through provider-assisted referral.",
    "The client will verbalize and demonstrate correct condom use and safer sex practices.",
    "The client will express feelings related to diagnosis and demonstrate healthy coping.",
    "The client will attend follow-up testing to confirm cure or ongoing viral suppression as applicable."
  ],
  "interventions": [
    {
      "title": "1. Providing nonjudgmental assessment and counseling",
      "points": [
        "Take a thorough, confidential sexual history using open-ended, nonjudgmental language to elicit accurate information.",
        "Create a private environment for discussion and ensure understanding of confidentiality protections and their limits.",
        "Normalize STI testing as a routine part of healthcare to reduce stigma and encourage honest disclosure.",
        "Assess emotional response to risk discussion or diagnosis and provide reassurance and support throughout.",
        "Avoid assumptions about sexual orientation, gender identity, or number of partners; ask direct, respectful questions."
      ]
    },
    {
      "title": "2. Testing and treatment",
      "points": [
        "Collect appropriate specimens (urine, cervical/urethral swab, blood) per current CDC or facility guidelines based on reported exposure sites.",
        "Administer or ensure prompt initiation of guideline-based antibiotic therapy for curable bacterial STIs (e.g., ceftriaxone for gonorrhea, doxycycline/azithromycin for chlamydia, penicillin for syphilis).",
        "Advise abstinence from sexual activity until treatment is completed and symptoms resolve, typically 7 days after single-dose therapy.",
        "For viral STIs, coordinate referral to specialty care (infectious disease for HIV) for antiretroviral or antiviral therapy initiation.",
        "Screen for co-infections, since patients with one STI are at increased risk for others, including HIV."
      ]
    },
    {
      "title": "3. Partner notification and reinfection prevention",
      "points": [
        "Discuss the importance of notifying and testing all recent sexual partners to prevent reinfection and further spread.",
        "Offer expedited partner therapy where legally permitted for eligible bacterial STIs.",
        "Provide resources for anonymous partner notification services when the patient is uncomfortable with direct disclosure.",
        "Encourage retesting at the recommended interval (e.g., 3 months) to detect reinfection, which is common with chlamydia and gonorrhea."
      ]
    },
    {
      "title": "4. Prevention education",
      "points": [
        "Teach correct and consistent condom use as the most effective barrier method for reducing STI transmission.",
        "Discuss HPV vaccination eligibility and encourage completion of the series if not already done.",
        "Discuss PrEP as an option for patients at high risk for HIV acquisition.",
        "Encourage regular STI screening based on risk factors and current guideline recommendations.",
        "Discuss the impact of substance use on sexual decision-making and offer resources for substance use treatment if relevant."
      ]
    },
    {
      "title": "5. Supporting chronic viral STI management",
      "points": [
        "Support adherence to antiretroviral therapy for HIV, emphasizing that consistent adherence achieves viral suppression and prevents transmission ('undetectable = untransmittable').",
        "Educate on recognizing and managing HSV outbreaks, including antiviral suppressive therapy options to reduce transmission and recurrence.",
        "Provide emotional support and connect to support groups or counseling for coping with a chronic, stigmatized diagnosis.",
        "Coordinate ongoing specialty follow-up and monitoring (CD4 count, viral load) for HIV-positive patients."
      ]
    },
    {
      "title": "6. Addressing psychosocial impact",
      "points": [
        "Acknowledge feelings of shame, anger, or fear that commonly accompany an STI diagnosis without minimizing them.",
        "Discuss the impact on current or future relationships and provide guidance on disclosure conversations with partners.",
        "Refer to counseling for patients struggling with the emotional impact of a chronic or stigmatized diagnosis.",
        "Reinforce that many STIs are common and treatable, and that a diagnosis does not define the patient's worth or character."
      ]
    }
  ],
  "patient_teaching": [
    "Complete the full course of prescribed antibiotics and abstain from sexual activity until treatment is finished and cleared by your provider.",
    "Notify all recent sexual partners so they can be tested and treated to prevent reinfection.",
    "Use condoms consistently and correctly with every sexual encounter to reduce risk of STIs.",
    "Attend follow-up testing appointments to confirm cure or, for chronic viral infections, monitor disease status.",
    "Consider HPV vaccination if eligible and not yet completed, regardless of age within the recommended range.",
    "Ask your provider about PrEP if you are at higher risk for HIV exposure.",
    "Understand that many STIs can be asymptomatic, so regular screening is important even without symptoms.",
    "Reach out for counseling or support resources if you are struggling emotionally with your diagnosis."
  ]
}