Sexually transmitted diseases (STDs) and sexually transmitted infections (STIs) are among the most common infectious diseases worldwide. They affect millions each year and can lead to serious health consequences, including infertility, chronic pain, cancer, and complications during pregnancy.
This guide focuses on three highly tested and clinically significant STDs: Gonorrhea, Herpes Simplex Virus (HSV types 1 and 2), and Human Papillomavirus (HPV). These infections differ in cause, transmission, and treatment, but share one critical fact — early diagnosis, treatment, and prevention are essential.
Gonorrhea
Overview & Pathophysiology
Gonorrhea is a bacterial infection caused by Neisseria gonorrhoeae. It primarily infects mucous membranes of the reproductive tract but can also affect the rectum, throat, and eyes. The bacteria spread through sexual contact and, if untreated, can cause pelvic inflammatory disease (PID), infertility, and increased risk of HIV transmission.
Key NCLEX Tip:
Untreated chlamydia and gonorrhea can cause infertility and PID — annual screening is recommended for sexually active individuals, especially women under 25.
Symptoms
- In men: Burning during urination, penile discharge, painful/swollen testicles.
- In women: Increased vaginal discharge, painful urination, bleeding between periods, pelvic pain.
- Many cases are asymptomatic — especially in women.
Diagnosis
- Nucleic acid amplification test (NAAT) – most accurate.
- Urine sample or swab from affected area.
Treatment
- Antibiotics: CDC recommends dual therapy (e.g., ceftriaxone + doxycycline/azithromycin).
- Treat sexual partners as well.
Patient Education
- NCLEX Tip: Sex partners must be evaluated and treated.
- Avoid sex until treatment is completed for both partners.
Herpes Simplex Virus (HSV)
Overview
Herpes is a viral infection caused by herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2).
- HSV-1: Primarily causes oral herpes (“cold sores”).
- HSV-2: Primarily causes genital herpes.
Pathophysiology
Once contracted, HSV remains in the body for life, hiding in nerve cells and reactivating periodically.
Symptoms
- Painful blisters or ulcers.
- Burning, itching before outbreak.
- Fever, swollen lymph nodes during first episode.
Key NCLEX Points:
- HSV is not curable but can be managed with antivirals (e.g., acyclovir).
- Genital herpes lesions during pregnancy require C-section to prevent neonatal infection.
- Condoms are ineffective during active lesions — avoid sex until healed.
HESI Question Tip:
Type 1 HSV clears up by itself in 10–14 days without treatment.
Human Papillomavirus (HPV)
Overview
HPV is the most common STD worldwide, with over 100 strains. Some strains cause genital warts, while others cause cancers such as cervical cancer.
Pathophysiology
HPV infects epithelial cells, and high-risk types (e.g., HPV-16, HPV-18) integrate into the host genome, leading to precancerous and cancerous changes.
Symptoms
- Often asymptomatic — people may not know they have it.
- Genital warts (small bumps or groups of bumps).
Prevention & Education
- Vaccination (ages 9–26).
- Annual Pap tests to detect cervical changes early.
- Avoid skin-to-skin contact with infected areas.
NCLEX Tip:
Condoms do not protect 100% against HPV — virus spreads via skin contact even when asymptomatic.
Comparison Table – Gonorrhea, HSV, and HPV
| Feature | Gonorrhea (Bacteria) | Herpes (Virus) | HPV (Virus) |
|---|---|---|---|
| Cause | Neisseria gonorrhoeae | HSV-1, HSV-2 | Human Papillomavirus |
| Curable? | Yes (antibiotics) | No (lifelong, managed) | No (managed, prevented) |
| Main Complication | PID, infertility | Recurrent painful outbreaks | Cervical cancer, genital warts |
| Transmission | Sexual contact, birth | Skin-to-skin, sexual contact | Skin-to-skin, sexual contact |
| Prevention | Condom use, partner treat. | Condom use, avoid during outbreak | Vaccine, screening |
Nursing & Exam Tips
- Always assess pregnancy status when teaching STD prevention — pregnancy complications are common with gonorrhea and herpes.
- Emphasize partner treatment and abstinence during active infections.
- HPV vaccination is a major public health measure to reduce cancer rates.
FAQs
Q1: Can you get gonorrhea from oral sex?
Yes, Neisseria gonorrhoeae can infect the throat during oral sex.
Q2: Is there a cure for herpes?
No — but antivirals reduce outbreaks and transmission risk.
Q3: Can HPV go away on its own?
Yes, many HPV infections clear spontaneously within 2 years, but high-risk strains can persist.
Q4: Do condoms prevent all STDs?
They greatly reduce but do not eliminate risk — especially for HPV and herpes.
Q5: Can you be infected with more than one STD at a time?
Yes — co-infections are common and can worsen health outcomes.
