Sex and sexuality involve complex human dynamics. The aim of patient education is to develop positive and protective factors to assist the client in achieving optimal sexual health.[7]
Sex is foremost about pleasure; whether it is masturbating alone, or with a companion; or physical, psychosocial or emotional intimacy in partnerships and relationships. Example discussion points for nurses when addressing HIV/STI prevention with clients include:
- The earlier an individual is diagnosed with an STI, the earlier it can be treated and transmission prevented. Recognising symptoms of STIs (dysuria, urethral discharge; genital pain) early may prompt an individual to access clinical services[8]
- Factors that contribute to STI transmission are dependent on the type of sexual activity people engage in.[9] The use of condoms is protective against most STIs, especially HIV. However, other STIs such as human papillomavirus (HPV) and herpes simplex virus (HSV) only require close genital skin-to-skin contact for transmission to occur[10]
- While condoms are considered the gold standard for prevention, there are alternative methods, referred to as biomedical prevention methods. These methods can involve the client taking antiretroviral drugs prophylactically following a high-risk exposure (post-exposure prophylaxis [PEP]) or before and ongoing, in the case of repeated high-risk exposures (pre-exposure prophylaxis [PrEP])[11] See HIV pre-exposure prophylaxis for more information.
- Concurrency in partnerships (having more than one partner at any one time) may occur throughout life. Factors that may contribute to concurrency may vary. However, ensuring that clients know the HIV status of their partner/s and the importance of open communication around what HIV/STI prevention strategies will be used with each type of partner is critical, i.e. regular partner/s versus casual partner/s.[12]