Sexually Transmitted Infections in Women: Are we doing Enough?

Review Article

Ann Nurs Res Pract. 2018; 3(2): 1030.

Sexually Transmitted Infections in Women: Are we doing Enough?

Stagg DL* and McCarthy J

College of Nursing and Allied Health, University of Louisiana at Lafayette, USA

*Corresponding author: Stagg DL, College of Nursing and Allied Health, University of Louisiana at Lafayette, USA

Received: October 23, 2018; Accepted: November 28, 2018; Published: December 05, 2018


Sexually Transmitted Infections (STI) are having a negative impact on society. Women are more impacted by the effects of STIs in terms of health complications. The STI’s of high concern are those of bacterial etiology. These infections can be treated if caught early, and thus decrease the negative health impacts. Healthcare providers and in a prime position to increase knowledge, testing, and treatment of STI’s. Knowledge of most common bacterial STI’s is important for any healthcare provider. Chlamydia, gonorrhea, and syphilis education, assessment, and treatment of women can decrease negative health impact on women and unborn children. Common myths and beliefs held by women regarding STI’s are important to be aware of for all healthcare providers. Healthcare providers can make a difference in health of women with an increased focus and awareness of STI’s.

Keywords: STI’s; Women; Women Health; STI Assessment; STI Treatment


STI’s in women: are we doing enough?

Sexually Transmitted Infections (STI) have been an issue for women’s health for decades. The rate of infection in new incidences is on the rise nationally. The impact on women is greater than that of men in terms of health consequences. STI’s of bacterial infections are of interest because they can be treated and cured, if caught early. Nurses are in a prime position to make a positive impact on decreasing the spread and impact of STI’s.

STI rates

While there are many infections that can be transmitted via sexual activities, they are not all noted as STI’s. STI’s are specific to those which are commonly contracted via sexual activity. It is important to note that sexually activity is not constrained to intercourse alone. The term sexual activity encompasses any activity having contact with the genitals or secretions of the genitals of one partner or both. Viral infections can be treated and managed to decrease the negative impact on health. Bacterial infections can be treated and cured, thus negating a negative impact on health, if diagnosed early.

The high focus bacterial STI’s of the CDC are:

• Syphilis (bacterial)

• Gonorrhea (bacterial)

• Chlamydia (bacterial)

According to the Center for Disease Control and Health Promotion (CDC) [1-4], the rate of STI’s has increased nationally over the last three years. The most notable increases were in Gonorrhea 18.5% increase, Syphilis 17.6% increase, and chlamydia 4.7% increase since 2015 [4]. While the increase is alarming, it is not impacting all populations equally. Age, race, and gender are significant risk factors. The CDC [1] reports the age group of 15 to 24-year-old account for more than half of all new STI infections. Women aged 40 and above have noted an increase in gonorrhea of 34% from 1996 to 2014 [2]. STI incidence is higher in African Americans, American Natives, and Hispanic Americans [5,6]. While syphilis is more prevalent in men than women, the CDC [5] reports and increase of 36% in primary and secondary syphilis in women from 2015 to 2016. These current statistics require prompt action on the part of all health care professionals. Women of all races endure more negative outcomes in their health and on their unborn children, as the risk for passing and STI to the fetus is high.

Impact on women

The effect of STI’s on women has a more profound effect on health. Additionally, women often to do not have clearly visible symptoms when trying to diagnose STI’s. In the recent CDC Sexually Transmitted Disease Surveillance Report, the CDC [4] notes that that young women, age 15 to 24, have 46% of reported cases and face the most severe consequences of an undiagnosed infection. Undiagnosed STI’s place women at increased risk for other health concerns such as pelvic pain, painful intercourse, infertility, and possible ectopic pregnancies, which have the potential to lead to death [5]. In addition to numerous negative health effects, once an individual is diagnosed with a STI, the risk for contraction of other STI’s increases.

Among the alarming increase, the CDC [5] reports the rise in syphilis in women, has led to a rise in congenital syphilis. This rise can result in undue stress in the infant, severe health complications, and death. The CDC reported more than 600 cases of congenital syphilis in 2016 [5]. The CDC reports an increase a 27.6% increase in congenital syphilis from 2015 to 2016, with 41 fetal syphilitic deaths in 2016 [7]. Syphilis is preventable and treatable.


If STI’s are preventable, and bacterial forms are treatable, why do the cases persist? This question may be answered by some

understanding of lay person’s beliefs regarding STI’s. Common myths held by the lay public:

Current evidence

There is existing research which may be beneficial for HCP’s to consider for treating STI’s. One approach is called Expedited Partner Therapy (EPT). This approach is state driven. According to CDC [3], EPT calls for partner notification and treatment for gonorrhea and chlamydia. In this approach, the infected partner, of the client, can also be given treatment for the infection without assessment or testing being performed. In some cases, the HCP may give the infected client the treatment for their partner as well, which the client will then give to their partner, upon leaving the clinic. This approach is dependent on state law. HCP’s should review their state laws where this approach is concerned. This approach is not recommended for syphilis. HCP’s must be clear to clients, that even though they are treated, they can still become re-infected if their partner is not also treated.

Another approach under investigation is known as “self-collected swabs”. According to Page, Mounsey & Rowland [11], self-collected swabs were more sensitive than clinician collected endocervical swabs. In this approach, women are asked to perform a self vaginal swab and submit for testing. Due to this research, there are now several at home testing kits that can be obtained for self -testing in women. The efficacy of each type of self-testing kit should be reviewed by the HCP prior to recommendation. This may be an option for those who have issues with coming to a clinical or MD office for testing. It may also be a point of education for community health driven events.


HCP’s are in a unique position to have a major positive impact on the education, detection, and treatment of STI’s. It is important that all HCP’s become informed on STI’s in terms of statistics, rates, signs, symptoms, testing, and treatment. HCP’ should then share this information with the clients they treat and encourage testing. Education performed in hospitals, health units, community health fairs, and local centers could increase awareness and potentially decrease contraction. Becoming comfortable with discussing STI’s can increase the possibility of clients getting tested. HCP’s can help in decreasing the stigma associated with STI’s and encourage early and frequent testing, by treating it like all other communicable diseases. HCP’s work with all populations, in all settings. Sharing knowledge with all individuals of contact, whether a client, family member, or friend, can assist in combatting this growing disease. Women are being impacted more severely, in terms of complications of STI’s. Many HCP’s are women and can assist in relating information on a sometimes difficult topic.


  1. Center for Disease Control and Health Promotion. Sexually Transmitted Diseases. 2018a.
  2. Center for Disease Control and Health Promotion. Selected STDs by Age, Race/Ethnicity, and Gender, 1996-2014 Request. 2018b.
  3. Center for Disease Control and Health Promotion. Expedited Partner Therapy. 2018c.
  4. Center for Disease Control and Health Promotion. The State of STD’s in the United States in 2016, infographic. 2017a.
  5. Center for Disease Control and Health Promotion. Reported STDs in the United States, 2016 High Burden of STDs Threaten Millions of Americans. 2017b.
  6. Center for Disease Control and Health Promotion. Sexually Transmitted Disease Surveillance in 2016. 2017c.
  7. Center for Disease Control and Health Promotion. Sexually Transmitted Disease Surveillance Updated September 26, 2017. 2017d.
  8. Center for Disease Control and Health Promotion. Chlamydia - CDC Fact Sheet. 2017e.
  9. Center for Disease Control and Health Promotion. Gonorrhea - CDC Fact Sheet. 2017f.
  10. Center for Disease Control and Health Promotion. Syphilis- CDC Fact Sheet. 2017g.
  11. Page C, Mounsey A, Rowland K. PURLs: Is self-swabbing for STIs a good idea? The Journal of Family Practice. 2013; 11: 651-653.

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Citation: Stagg DL and McCarthy J. Sexually Transmitted Infections in Women: Are we doing Enough?. Ann Nurs Res Pract. 2018; 3(2): 1030.

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