Download MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st Year, 2nd Year, 3rd Year and Final year Venereology and Leprosy 4 Sti Counselling PPT-Powerpoint Presentations and lecture notes
STI Counselling
? Counselling has been defined by Burnard
(1999) as " the means by which one person
helps another to clarify his or her life situation
and to decide further lines of action "
Role of counsellor
? Understands the reasons for these symptoms
(including past sexual behaviours)
? Understands that only a complete course of treatment
wil help the situation
? Decides how to avoid future infection
? Decides what to do to protect other people from their
symptoms/ il ness (e.g., referring the sexual partner for
treatment)
Signs and symptoms of STI in males
? Urethral discharge/ burning or pain during urination/
frequent urination
? Genital itching
Swel ing in groin/ scrotal swel ing
Blisters or ulcers on the genitals, anus, mouth, lips
? Itching or tingling in genital area
Ano-rectal discharge
Warts on anal, genital region or surrounding area
Signs and symptoms of STI in females
? Abnormal vaginal discharge
? Genital itching
? Pain during sexual intercourse
? Lower abdominal pain
? Blisters/ulcers on the genitals, anus or
surrounding area, mouth, lips
Steps of counselling
1) Information
2) Risk assessment and risk reduction
3) Investigation and treatment
4) Partner management
5) Follow up
Information
? STI, HIV/AIDS, Oppurtunistic infections
? Explore any myths and misconceptions and
clarify the same
? Repeat and summarise information
? Ask questions to check whether they have
understood
Risk assessment
? Detailed sexual history
1 . Greet the patient and introduce yourself
2 . Take consent
3. Ask about history of presenting complaint
and duration
4. Ask about sexual orientation
homo/heterosexual .
5. Ask about marital status
6. Ask about last sexual encounter (date]
7. Nature of contact- M arital / non marital
8. Type of contact ? genitogenital, orogenital,
anogenital
9. Type of contraception used and consistency of
usage
10. Number of sex partners in the last 3 months-
regular/ casual
11. Ask if patient has ever paid for sex
12. If patient or his partner has been tested for
HIV or any other STD in past?
13. If patient or his partner has ever been diagnosed with
any STD in past
14. If patient or his partner has any recurring STD
complaints
15. If patient s partner has similar complaints currently
16. Ask if patient has ever had sexual contact under
influence of alcohol
17. History of use of any drug oral/ IV/ Needle sharing
High risk sexual behaviour
? Unprotected
genitogenital/anogenital/orogenital
intercourse except in a long term
monogamous relationship
? Having multiple sex partners
? Having a high risk partner ( who has multiple
sex partners or other risk factors)
? IV drug users
? Sex trade work
Risk reduction
? Address each and every high risk behaviour
mentioned by the patient
? Give a specific suggestion for how to make it
safer
? Strongly recommend use of condom
? Correct misinformation
Investigations and treatment
? HIV testing ( Pre test and post test counselling
)
? VDRL
? HBsAg, Anti HCV antibodies
? Genital ulcers- Tzanck smear/Gram stain/Dark
ground illumination
? Discharge (uretheral/cervical/vaginal)- Gram
stain/KOH mount/Wet mount/Culture/PCR
? Emphasis on completing the treatment
? Suggest abstinence while on treatment
? Follow up visit after completing the course of
treatment
Partner management
-- STI re-infection
-- Further spread of STI
-- Possible long term effects of untreated STI
for the partner
Approaches to partner management
? Referral by index client
? Referral by STI service provider
(CONTACT TRACING)
QUIZ
1) Following occupational (needle stick)
exposure, which of the following diseases has
the highest risk of transmission?
a) HIV
b) HCV
c) HBV
d) All of the above
Answer
c) HBV ( 9-30%)
HCV (1-10%)
HIV ( 0.3 %)
2) What is the drug of choice for syphilis
infection?
Answer
Penicillin
3) Which of the following types of sexual contact
has the highest risk of HIV transmission?
a) Orogenital
b) Genitogenital
c) Anogenital
d) All have the same risk of transmission
Answer
C) Anogenital
4) In which of the following diseases
lymphadenopathy is NOT seen?
a) Syphilis
b) Herpes genitalis
c) Donovanosis
d) Chancroid
? Answer - Donovanosis
5) On gram staining " school of fish" appearance
is seen in :
a) Chancroid
b) Donovanosis
c) Lymphogranuloma venerum
d) None
Answer
a) Chancroid
Thank you!!
This post was last modified on 08 April 2022