Unit 14 Reducing risk of STIs and HIV, care and support
Key unit competence: Explain how to reduce the risk of STIs and HIV and show care, support and non-discrimination for people living with HIV.
Key ideas
- Sexually transmitted infections (STIs) spread mainly through sexual contact. Examples: gonorrhoea and syphilis (bacteria; treated with antibiotics), chlamydia (bacterium), genital herpes and HPV (viruses), trichomoniasis (protoctist), candidiasis (fungus) and HIV.
- Common signs: unusual discharge, pain or burning when urinating, sores, itching or rashes on the genitals, lower abdominal pain. Many STIs have no signs at first, so testing is important. Untreated STIs can cause infertility, ectopic pregnancy, infection of babies at birth and a higher risk of HIV.
- HIV (Human Immunodeficiency Virus) attacks CD4 (T-helper) lymphocytes, weakening the immune system. Without treatment it leads to AIDS (Acquired Immune Deficiency Syndrome), when opportunistic infections such as TB, pneumonia and some cancers develop.
- HIV spreads through infected blood, semen, vaginal fluids and breast milk: unprotected sex, sharing needles or sharp objects, unscreened blood, and mother-to-child transmission (pregnancy, birth, breastfeeding). It does not spread by hugging, shaking hands, sharing food, cups or toilets, or by mosquito bites.
- Reducing risk (ABC and more): Abstinence; Being faithful to one tested, uninfected partner (for adults); correct and consistent Condom use; HIV testing and counselling; treating STIs early; not sharing sharp objects; PMTCT (prevention of mother-to-child transmission); PEP within 72 hours after exposure; voluntary medical male circumcision lowers risk for men; avoiding alcohol and drugs.
- Antiretroviral therapy (ART) does not cure HIV, but reduces the amount of virus so the immune system recovers. People taking ART every day can live long, healthy lives, and when the virus is undetectable it is not passed on sexually.
- Positive living: taking ART daily, eating a balanced diet, exercising, avoiding alcohol and smoking, treating infections early, attending clinic visits, and joining support groups.
- Rights of people living with HIV (PLHIV): the same rights as everyone: education, work, health care, privacy and confidentiality, marriage and family, and protection from discrimination.
- Stigma and discrimination (insults, isolation, denying jobs or school) make people afraid to test or take treatment. Care and support: emotional support, help with daily needs, encouraging adherence to ART, including PLHIV in activities.
Common misconceptions
- "HIV spreads by sharing cups, toilets or hugs." No: HIV spreads only through blood, sexual fluids and breast milk.
- "Mosquitoes can transmit HIV." No: HIV cannot survive or multiply in mosquitoes.
- "A healthy-looking person cannot have HIV." No: people can look healthy for years; only a test shows HIV status.
- "ART cures HIV." No: ART controls the virus but must be taken for life.
Worked examples
Example 1. Explain how HIV weakens the body's defence against disease.
Solution
HIV infects and destroys CD4 lymphocytes, which coordinate the immune response. As their number falls, the body cannot make an effective response to pathogens, so opportunistic infections (TB, pneumonia, thrush) attack. This late stage is AIDS.
Example 2. A pregnant woman learns she is HIV-positive. Explain how her baby can be protected.
Solution
Through PMTCT: she starts ART at once and takes it daily, which lowers the virus in her blood; she gives birth in a health facility with safe practices; the baby receives preventive medicine; she follows advice on safe infant feeding and the baby is tested.
Practice questions
Name four STIs and the type of pathogen that causes each.
Show answer
Gonorrhoea (bacterium); syphilis (bacterium); chlamydia (bacterium); herpes (virus); HPV (virus); HIV (virus); trichomoniasis (protoctist); candidiasis (fungus).
Common mistake: Saying all STIs are caused by viruses.
State four ways in which HIV is transmitted and two ways it is not.
Show answer
Transmitted: unprotected sex; sharing needles or sharp objects; unscreened blood; mother to child. Not transmitted: hugging, sharing cups or toilets, mosquito bites, shaking hands.
Common mistake: Including mosquito bites as a route.
Explain the ABC approach to HIV prevention.
Show answer
A: Abstinence (no sex); B: Be faithful to one tested uninfected partner (adults); C: correct and consistent Condom use.
Common mistake: Saying C stands for cure.
Distinguish between HIV and AIDS.
Show answer
HIV is the virus that attacks CD4 cells; AIDS is the late stage of untreated HIV infection, when the immune system is very weak and opportunistic infections occur.
Common mistake: Using the words as the same thing.
State four rights of people living with HIV.
Show answer
Right to education, work, health care, privacy/confidentiality, marriage and family, and freedom from discrimination.
Common mistake: Saying PLHIV should be isolated.
Give four ways the community can support people living with HIV.
Show answer
Show love and acceptance; avoid stigma; encourage adherence to ART; help with food and daily needs; include them in activities; support groups.
Common mistake: Treating them as dangerous.
Explain how ART helps people living with HIV.
Show answer
ART reduces the amount of virus in the body, letting CD4 cells recover; the person stays healthy and lives longer; an undetectable virus is not transmitted sexually.
Common mistake: Saying ART cures HIV.
Explain why early testing and treatment of STIs is important.
Show answer
Many STIs have no signs; early treatment prevents complications such as infertility, protects partners and babies, and lowers the risk of HIV infection.
Common mistake: Waiting for signs before testing.
Matching and drag-and-drop
Matching
Match each item in column A with the correct answer in column B. Write the letter next to each number.
Column A Column B 1. A group where PLHIV share experiences and encourage each other is a: a. adherence 2. Positive living for PLHIV includes: b. Blood 3. Which body fluid can transmit HIV? c. support group 4. Taking ART every day as prescribed is called: d. a balanced diet and regular ART Show answer
1 → c (support group) · 2 → d (a balanced diet and regular ART) · 3 → b (Blood) · 4 → a (adherence)
- It reduces isolation.
- It keeps the immune system strong.
- Blood, semen, vaginal fluids and breast milk can.
- Missing doses lets the virus multiply.
Drag and drop
Choose the correct word or phrase from the box for each gap. One word in the box is not needed.
infertility · sexual contact · stronger bones · abstinence- An untreated STI can cause .
- STIs are spread mainly through .
- The A in the ABC of HIV prevention stands for .
Show answer
1: infertility · 2: sexual contact · 3: abstinence
- Infections can block oviducts or sperm ducts.
- Some also spread through blood or from mother to child.
- B is Be faithful and C is Condoms.
Matching
Match each item in column A with the correct answer in column B. Write the letter next to each number.
Column A Column B 1. A sign that may suggest an STI is: a. lowers men's risk of HIV infection 2. Unfair treatment of a person because of their HIV status is: b. unusual genital discharge 3. AIDS stands for: c. discrimination 4. Voluntary medical male circumcision: d. Acquired Immune Deficiency Syndrome Show answer
1 → b (unusual genital discharge) · 2 → c (discrimination) · 3 → d (Acquired Immune Deficiency Syndrome) · 4 → a (lowers men's risk of HIV infection)
- Many STIs also have no signs.
- It violates their rights.
- It is the late stage of HIV infection.
- It reduces risk but condoms are still needed.
Drag and drop
Choose the correct word or phrase from the box for each gap. One word in the box is not needed.
one month of exposure · prevention of mother-to-child transmission · 72 hours of exposure · bacteria- PMTCT means .
- PEP should be taken within .
- Gonorrhoea and syphilis are caused by .
Show answer
1: prevention of mother-to-child transmission · 2: 72 hours of exposure · 3: bacteria
- It protects babies from HIV.
- The sooner, the better.
- They are treated with antibiotics.