Postexposure Prophylaxis against Sexually Transmitted Infections

by Michael_Koger

For prevention of disease transmission via sexual contact, specific protocols are available.

The occurrence of sexually transmitted disease varies with the microorganism. Much data collection has taken place to explore these trends. For example, viral hepatitis can transmit via contact with blood and body fluids. For hepatitis A and B, postexposure prophylaxis measures are available, but this is not the case for hepatitis C. Effective vaccines for hepatitis A and B are beneficial to prevent the illness in nearly anyone, but there is not an effective method for hepatitis C [1].

Sexual transmission of hepatitis A and B is well-known, but many physicians have said for years that hepatitis C does not spread via sex. Hepatitis C transmits mainly by injecting drug use; however, in recent years, physicians have acknowledged sexual transmission of hepatitis C especially in men who have sex with men. This is especially true in men who have unprotected anal sex with multiple partners.

Hepatitis C virus can also spread via transfusion of blood or blood products which have not undergone adequate screening. Moreover, reuse of medical equipment without sterilization can transmit hepatitis C [3].

Common Infections

     In any event, the clinician will need to know whether seroconversion has taken place in anyone who has had percutaneous exposure—through the skin--to hepatitis C.  In other words, serologic testing will inform the health care team whether or not the patient has acquired this infection [1].

     Of all bloodborne viruses, hepatitis B is the one most likely to lead to infection [1].  It is particularly important that pregnant women who may have suffered exposure to hepatitis B receive hepatitis B vaccine or immunoglobulin or both.  Such a procedure dramatically lowers the possibility of transmission to the fetus [1].

     In the United States, “chlamydia is the most commonly reported communicable disease [1].”  The risk of transmission is 65 percent when an individual without the infection has sex with someone who has it.  Also, the more times that a person has sex with an infected individual, the greater will be the risk of acquisition [1].

     For primary or secondary syphilis, the risk of acquisition is 30 percent.  This applies, of course, to someone who does not have syphilis and who has a sexual encounter with a person who already has the infection.

     The risk of gonorrhea transmission ranges from 50 to 93 percent.

     Finally, one must remember that sexual assault is a special situation.  These clients will require prophylaxis against chlamydia, gonorrhea, trichomoniasis, human immunodeficiency virus, and several other microorganisms.  If the victim is a woman of child-bearing age who does not use birth control, emergency contraception is necessary [1].

Conclusion

     The management of exposure to sexually transmitted disease is complex and requires awareness of the medical team as well as members of the community in order to have the best result.

References

  1. Bader, M., Brooks, A., Kelley, D., and Srigley, J.  (2017).  Postexposure management of infectious diseases.  Cleveland Clinic Journal of Medicine, 84, 65-80.
  2. World Health Organization.  (2017).  Post-exposure prophylaxis.
  3. World Health Organization.  (2017).  Hepatitis C.
  4. The photo shows a library at the U.S. Centers for Disease Control.  Reprinted with permission of that organization.
  5. Copyright 2017, Michael Koger, Sr., All Rights Reserved.

Disclaimer

     The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 05/21/2017, Michael_Koger
 
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