Pharmacists Can Educate Patients on Sexually Transmitted Infections

Globally, approximately 376 million new sexually transmitted infections (STIs) are diagnosed each year.¹ In the US, the continuous rise in STIs represents a significant public health challenge. In 2022, the CDC reported over 2.5 million cases of syphilis, gonorrhea, and chlamydia.² The rise in syphilis and congenital syphilis is notably concerning, calling for urgent measures to enhance STI prevention. Although syphilis cases have increased, gonorrhea cases decreased for the first time in a decade, and chlamydia cases stayed the same.²

Pharmacist talking to a patient | Image credit: Reese/peopleimages.com | stock.adobe.com

Educating patients about STIs is essential for a number of reasons. Timely detection and treatment can avert severe health problems, minimize the spread of infections, and reduce the stigma associated with these diseases. Moreover, patients who are well-informed are more likely to engage in safer sexual practices. Health care providers can play a significant role in combating the STI epidemic by encouraging open communication and utilizing educational resources to counsel patients. Common misconceptions should also be addressed. Additionally, pharmacists can play a vital role in preventing and managing STIs by providing education on safe sex practices, medications, and ensuring access to regular screenings and preventive treatments.

STIs are primarily transmitted through sexual contact, including vaginal, anal, and oral sex, or from mother to child during childbirth. They can also spread through contact with infected bodily fluids or sores.³ STIs can be caused by bacteria, viruses, or parasites. The most common STIs include bacterial infections such as chlamydia, gonorrhea, and syphilis. In contrast, trichomoniasis is caused by a parasite.⁴

Viral infections are also major contributors to STIs and include human papillomavirus (HPV), herpes simplex virus (HSV), human immunodeficiency virus (HIV), and hepatitis B. If left untreated, these infections can lead to additional health complications, including infertility, chronic pain, and an increased risk of other infections.⁴ Significant risk factors include engaging with multiple sexual partners, having unprotected sex, and sharing needles. Table 1^5-9 provides an overview of various STIs as well as transmission, symptoms, and treatments.

Table 1^5-9

STIs can be asymptomatic or present with visible symptoms such as rashes, discharge, or sores. Recognizing early signs and seeking medical care is essential for effective treatment and preventing long-term health complications.

Moreover, STIs pose serious health risks and complications for both men and women. In males, gonorrhea and chlamydia can cause epididymitis, which can lead to testicular pain, swelling, and potential infertility. These infections also increase the susceptibility to HIV because the genital mucosa gets compromised.

In women, untreated STIs can result in pelvic inflammatory disease (PID), which can damage the uterus, fallopian tubes, and ovaries. As a result, this leads to chronic pelvic pain, ectopic pregnancies, and infertility. The human papillomavirus (HPV) poses a high risk of cervical, anal, and other genital cancers.

STIs during pregnancy can result in adverse outcomes, including premature birth, low birth weight, and neonatal infections. As pharmacists, we have a vital role in addressing these complications and supporting optimal reproductive health. Table 2¹⁰ reviews counseling strategies pharmacists can employ for effective STI prevention efforts and table 3^11,12 outlines available vaccines for STIs and sexually transmitted viruses. Finally, table 4^15,16 lists available tests for STIs.

Table 2¹⁰

Table 3^11,12

Table 4^15,16

Overall, the increasing occurrence of STIs highlights the importance of thorough patient education to promote early detection, effective treatment, and the reduction of stigma. Pharmacists should educate patients on safe sex practices, regular screenings, and preventive care. With vaccines like hepatitis B and HPV offering substantial protection, preventive measures are essential. By prioritizing education and early intervention, healthcare providers can decrease STI rates and enhance public health outcomes.

About the Author

Anjeza Fero, PharmD, RPh, works at Alexion Pharmaceuticals/AstraZeneca in the rare diseases field and is a professor at the University of Connecticut.

REFERENCES

1. Garcia MR, Wray AA. Sexually Transmitted Infections. PubMed. Published May 30, 2023. https://www.ncbi.nlm.nih.gov/books/NBK560808/

2. Sexually Transmitted Infections Surveillance, 2022. www.cdc.gov. Published January 29, 2024. https://www.cdc.gov/std/statistics/2022/default.htm#:~:text=Overall%2C%20in%202022%2C%20more%20than

3. CDC. About Sexually Transmitted Infections (STIs). Sexually Transmitted Infections (STIs). Published April 22, 2024. https://www.cdc.gov/sti/about/index.html

4. Mayo Clinic. Sexually transmitted diseases (STDs) - Symptoms and causes. Mayo Clinic. Published September 8, 2023. https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240

5. Cleveland Clinic. Chlamydia symptoms, treatment, prevention & complications. Cleveland Clinic. Published 2021. https://my.clevelandclinic.org/health/diseases/4023-chlamydia

6. Mayo Clinic. Gonorrhea - Diagnosis and treatment - Mayo Clinic. Mayoclinic.org. Published 2018. https://www.mayoclinic.org/diseases-conditions/gonorrhea/diagnosis-treatment/drc-20351780

7. Syphilis: Symptoms, Causes, and Treatments. Yale Medicine. Accessed July 26, 2024. https://www.yalemedicine.org/conditions/syphilis#:~:text=Sores%2C%20known%20as%20mucous%20patches

8. Mayo Clinic. Trichomoniasis - Symptoms and causes. Mayo Clinic. Published 2022. https://www.mayoclinic.org/diseases-conditions/trichomoniasis/symptoms-causes/syc-20378609

9. Cleveland Clinic . Human Papilloma Virus (HPV) | Cleveland Clinic. Cleveland Clinic. Published August 4, 2022. https://my.clevelandclinic.org/health/diseases/11901-hpv-human-papilloma-virus

10. CDC. Primary Prevention Methods. www.cdc.gov. Published August 12, 2021. https://www.cdc.gov/std/treatment-guidelines/clinical-primary.htm

11. HIGHLIGHTS of PRESCRIBING INFORMATION. https://www.fda.gov/media/119403/download?attachment

12. Patient Information about GARDASIL®9 (Pronounced “Gard-Ah-Sill Nīn”) (Human Papillomavirus 9-Valent Vaccine, Recombinant). https://www.merck.com/product/usa/pi_circulars/g/gardasil_9/gardasil_9_ppi.pdf

13. Policy (OIDP) O of ID and H. Hepatitis B. HHS.gov. Published April 27, 2021. https://www.hhs.gov/immunization/diseases/hepatitis-b/index.html#:~:text=Hepatitis%20B%20is%20a%20common1

14. CDC. HPV Vaccine. Centers for Disease Control and Prevention. Published 2020. https://www.cdc.gov/vaccines/vpd/hpv/hcp/vaccines.html

15. Get Tested. www.ashasexualhealth.org. Published August 21, 2014. https://www.ashasexualhealth.org/get-tested/

16. Planned Parenthood. Planned Parenthood. Plannedparenthood.org. Published 2019. https://www.plannedparenthood.org/learn