What should be included in patient education about gonorrhea?

Updated: Sep 07, 2018
  • Author: Brian Wong, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Discuss safe sexual practices with all individuals in whom gonorrhea is suspected. Proper education to prevent gonorrhea may be more effective than simplistic instructions to avoid sex, especially in the teenaged population. Teenagers involved with abstinence-only campaigns have unchanged STD rates and disproportionately acquire anal and oral infections, rather than vaginal infections (the perception being that if an activity is not vaginal sex, it is not sex). Stress that oral or anal sex can also transmit disease.

Patients should know the method of disease transmission and the adverse impact of recurrent infections on future fertility, they should be counseled about the risks of complications following gonococcal infection and the risk of other STDs, and they should always be instructed to refer any sex partners for prompt evaluation and treatment.

In addition, these individuals should be aware that they should avoid sexual contact until medication is finished and until their partners are fully evaluated and treated. Thereafter, they should avoid unprotected contact.

The discussion of responsible sexual behavior should not be limited or withheld because of personal religious or moral views, because these may not be shared by the patient, and teenagers are notorious for sexual experimentation; evidence suggests that offering only limited discussion does the teenage population a huge disservice. This advice is especially pertinent in states where sexual education is almost nonexistent in the school system because of abstinence-only teaching, which is misleading and factually inaccurate.

In one study in Peru, a bundle of interventions that included extensive public health efforts, including training of local medical personnel, specific and presumptive treatment, outreach to female sex workers, and supply of barrier contraception, may have been effective at reducing the prevalence of several STDs, although the effect did not reach statistical significance overall.

The effects were more greatly pronounced (and significant) among female sex workers and young adult women. The study was hampered by several methodologic limitations, such as comparing different cities as controls, which made drawing conclusions from the data difficult. [35]


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