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Answer to Case Study #3:Patricia’s vaginal discharge may be related to an STI (chlamydia, gonorrhea, or trichomonas infection) or to a nonsexually transmitted reproductive tract infection (RTI) (bacterial vaginosis [BV] or yeast infection). It is not possible to tell the cause based on the history alone. If the discharge is due to a chronic yeast infection, she could be infected with HIV. Since she has multiple partners and does not use condoms, it is also possible that her discharge is related to repeated episodes of STI. She may be getting cured after treatment, but then getting reinfected. When you counsel Patricia,
it is important to explore what she knows about HIV and other STIs and
how she perceives her own risk for infection. It is also critical to address
condom use, making sure that she knows how to use condoms correctly by
observing her put one on a penis model. Discuss strategies for motivating
her partners to use condoms, and practice these communication skills through
role plays. If female condoms are available in your area, discuss with
Patricia the possibility of her using them. Depending on the availability
and accessibility of HIV testing services, you might discuss the option
of HIV testing with Patricia.
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