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# STI counselling: risk reduction, testing, partner notification and condom teaching

- Safe practice

The nurse takes a respectful sexual history, offers testing, teaches correct condom use and helps the person tell and treat partners.

Updated Nov 13, 2026

## Key points

- The 5 P's of the sexual history (CDC): partners, practices, protection from STIs, past STIs and pregnancy intention.
- Counselling works best when it is empathetic, non-judging and fitted to culture, language, gender identity, orientation and age.
- Correct and consistent condom use is highly effective, but it protects less against infections that cause sores (syphilis, herpes).
- Vaccines prevent hepatitis B and HPV infection.
- Treating sexual partners prevents reinfection.

## What it is

Most sexually transmitted infections cause no symptoms, so prevention depends on asking, testing and teaching (WHO). STIs cause infertility, cancer and pregnancy complications, and raise the risk of HIV. Nursing counselling uses a non-judging sexual history, tailored risk reduction, testing, vaccination, correct condom use and partner treatment. Chlamydia, gonorrhoea, syphilis and trichomoniasis are curable; herpes, HIV and hepatitis B are controlled, not cured.

## What it requires

- WHO: more than 1 million curable STIs are acquired every day among people aged 15–49, and most have no symptoms.
- Chlamydia and gonorrhoea are major causes of pelvic inflammatory disease in women.
- Syphilis in pregnancy causes stillbirth, newborn death and congenital disease.
- Rapid tests exist for syphilis, HIV and hepatitis B.
- Gonorrhoea resistance to antibiotics is a growing threat.

## Components

- Risk assessment with the sexual history.
- Tailored risk-reduction counselling with goals the person sets.
- Testing, vaccination and condom teaching.
- Partner notification and treatment, and follow-up.

## How it is applied (and why)

- Offer privacy and explain that the questions are routine for everyone — normalising lowers shame and improves honest answers.
- Take the 5 P's with open, plain questions — they show the risk and which tests to offer.
- Agree on one or two concrete goals with the person (for example, condom with new partners) — personal goals work better than general warnings.
- Offer the tests that apply, rapid tests included, and explain how she will get her results — most infections have no symptoms.
- Check the hepatitis B and HPV vaccines and refer to vaccination if missing — vaccines prevent infection before exposure.
- Teach condoms with a model: check expiry, open by hand, put on before any contact, squeeze the tip, unroll to the base — most failures come from wrong use.
- Teach a new condom each time, water- or silicone-based lubricant only, never two at once, withdraw holding the base — oil and friction break latex.
- If there is an infection, explain why partners must be told and treated, and how the service helps — untreated partners cause reinfection.
- Advise no sex until treatment is complete, and book the follow-up — this stops transmission during treatment.

## In nursing practice

- Adolescents may come alone or with a companion they choose, as in contraception counselling (Res. 3280).
- A pregnant woman with an STI enters the ETMI-plus route: HIV, syphilis and hepatitis B tests and follow-up of the newborn.
- Signs of sexual violence or a child under 14 who is sexually active: activate the sexual violence route.
- Do not use nonoxynol-9 spermicide with condoms: it irritates the skin.

## Common mistakes

- Asking only people who «look at risk».
- Judging or moralising during the history.
- Teaching condoms without a model or skipping the tip and base steps.
- Treating the person and forgetting the partners.
- Storing condoms in a wallet or using oil-based lubricants.

## Test yourself

Think of the answer, then tap the question to see it.

## What are the 5 P's of the sexual history?

Partners, practices, protection from STIs, past history of STIs and pregnancy intention.

## Why does a condom protect less against syphilis and herpes?

Because these infections cause sores that may be on skin the condom does not cover.

## Which lubricant can be used with a latex condom?

Water- or silicone-based lubricant; oil-based products such as petroleum jelly or lotion can break it.

## Why are sexual partners treated?

Treating partners prevents reinfection of the person and further transmission.

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## Connections

## Related 3

- [Preventing mother-to-child transmission of HIV, syphilis, hepatitis B and Chagas (ETMI-plus): tests, timing and follow-up](https://durgical.com/en/nursing/preventing-mother-to-child-transmission-of-hiv-syphilis-hepatitis-b-and-chagas-t/)
- [Contraception counselling: the methods, eligibility in general terms, LARC and after birth or abortion](https://durgical.com/en/nursing/contraception-counselling-the-methods-eligibility-in-general-terms-larc-and-afte/)
- [Youth-friendly health services for adolescents and young people](https://durgical.com/en/nursing/youth-friendly-health-services-for-adolescents-and-young-people/)

## Related conditions 5

- [Chlamydia infection](https://durgical.com/en/conditions/chlamydia-infection/)
- [Gonorrhoea](https://durgical.com/en/conditions/gonorrhoea/)
- [Trichomoniasis](https://durgical.com/en/conditions/trichomoniasis/)
- [Syphilis](https://durgical.com/en/conditions/syphilis/)
- [Human papillomavirus (HPV) infection](https://durgical.com/en/conditions/human-papillomavirus-infection/)

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Sexually transmitted infections (STIs) (fact sheet)](https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)) (World Health Organization, 2025); [STI risk assessment (STI Treatment Guidelines)](https://www.cdc.gov/std/treatment-guidelines/clinical-risk.htm) (Centers for Disease Control and Prevention, 2021); [Primary prevention methods (STI Treatment Guidelines)](https://www.cdc.gov/std/treatment-guidelines/clinical-primary.htm) (Centers for Disease Control and Prevention, 2021); [How to use an external condom](https://www.cdc.gov/condom-use/resources/external.html) (Centers for Disease Control and Prevention, 2024).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/sti-counselling-risk-reduction-testing-partner-notification-and-condom-teaching/