Chapter 18: Sexually transmitted infections
How STIs are passed
To get an STI, a person must have close contact with someone who is already
infected. The contact can be sexual intercourse (sex with the man’s penis inside the
woman’s vagina), anal sex (penis in anus), or less often, oral sex (mouth on
genitals or anus). STIs can sometimes pass from just rubbing an infected penis or
vagina against another person’s genitals. Many people get STIs from people who
have no signs of being infected.
STIs can be prevented by not having sex with anyone who has an infection.
Many STIs can be prevented by using condoms. To learn about preventing STIs,
see pages 334 and 336.
Babies can also be infected with an STI through the mother’s blood during
pregnancy or during birth when they pass through the vagina.
Most STIs will get better or go away if the person with the STI gets treated right
away. But many women do not get treatment. A woman may not be able to afford
treatment. She may feel embarrassed or ashamed. She may be afraid that her
husband will think she had sex with someone else.
For these reasons, the way you care for a woman who may have an STI is
very important. If a woman comes to you for help, do not tell anyone else what
she told you. She may not come to you for help again. Do not criticize her.
Answer her questions honestly, and as best as you can. If you cannot treat her
infection, help her find low-cost care nearby.
• Treat STIs as soon as possible. Early
treatment for STIs costs less and is
more effective than later treatment.
• Treat partners too. Treating a woman
for an STI will not help if her partner
is still infected.
• Make sure the woman takes all the
medicine she is given. Even if the
signs of infection go away, a person
must take all the medicine to cure
the infection completely.
go to the
But if we don’t
both get cured
we’ll just get
Note: All the medicines listed in this chapter are safe to take during
pregnancy or while breastfeeding unless we include a warning that
says they are not safe. Women who are not pregnant or breastfeeding
may be able to take other, more effective drugs. See the book Where
Women Have No Doctor or talk to a pharmacist to find out about
A Book for Midwives (2010)