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Hesperian Health Guides

Educate on family planning and STIs

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HealthWiki > Workers' Guide to Health and Safety > Chapter 26: Reproductive and sexual health > Educate on family planning and STIs


In this chapter:

Many people work in a factory during the period in their lives where they are likely to be most sexually active. It is important that they have information about and access to resources on family planning, sexual health, and how to prevent and treat sexually transmitted infections (STIs).

Workers and worker organizations can collaborate with women’s organizations, health workers, nonprofit organizations, and even government health officials to design workshops on:

  • early detection of cancer
  • family planning
  • STI tests and treatments, and prevention
a woman speaking near a van that advertises "Free health exams."
I had never heard of the Pap test until the Chinese Working Women’s Network health van came to our factory zone and offered free exams.

Workshops are most effective when they include discussions and activities that encourage people to explore how work, culture, society, family, and personal preferences affect their reproductive and sexual health. They should also include information on community resources, such as free or low-cost clinics and government programs, and on the best ways to educate and provide services within the factory.

A workers’ health committee can invite organizations that offer free or lowcost STI exams and treatment, maternity care, breast exams, Pap and vinegar tests, and family planning services to your community.

The rest of this chapter provides information on these topics that you can use in workshops. Make sure to talk with women and men at the factory to find out the issues they think are most important for workshops.

Information about family planning

Family planning is having the number of children you want, when you want them. If you want to wait to have children, you can choose one of several methods to prevent pregnancy. These methods are called family planning, child spacing, or contraception. Condoms for men and condoms for women are the only methods that also prevent sexually transmitted infections. Each method works better for some people than for others, and women with certain health problems should avoid certain methods. The chart below shows advantages and disadvantages of each method. Talk to a health worker to decide which might be best for you.

Health
Info


Types of family planning Preventing
Pregnancy
Protection
from STIs and HIV
How often Other important
information
Condoms

Good Best Every time Most effective when used with a spermicide and a water-based lubricant. A condom needs to be used every time you have sex.
Birth control pills

Very good None Every day Important to take at the same time every day. Talk to a health worker if you have had breast cancer, have high blood pressure or liver disease, or if you are pregnant or nursing.
Implants

Best None 3 or 5 years Must be inserted and removed by a specially trained health worker and replaced every 3 or 5 years depending on the type.
Injections

Very good None 1, 2, or 3 months Need to be repeated every 1, 2, or 3 months depending on the type.
IUD

Best None 5 or 12 years Effective for 5 or 12 years depending on the type. Must be inserted and removed by a specially trained health worker.
Pulling out (withdrawal)

Least None Every time The man needs to withdraw every time you have sex. Even if he pulls out, some liquid from the penis may enter the vagina during sex, which can cause pregnancy or pass STIs.
Breastfeeding (during the first 6 months only)
Very good None Breastfeeding several times a day and at night This method is only effective if the woman is feeding her baby only breast milk and if her menstruation has not returned.
Fertility awareness

Good None Every time This method does not work well for women with irregular menstrual cycles.
Sex without intercourse (penis not inside vagina)
Best Depends Every time If the penis is not inside or touching the vagina, the woman cannot get pregnant. Anal sex can easily pass STIs, oral sex is less likely to pass STIs, and sexual touch rarely passes any STIs.
Sterilization

Best None Once Once a woman or man is sterilized, they will never become pregnant or get someone pregnant.


For more information about family planning, see Where There Is No Doctor, or Where Women Have No Doctor.

Unwanted pregnancies

Many women have unwanted pregnancies, especially if their partners, families, communities, or workplaces prevent them from getting family planning information and services or making choices that are best for them.

Prevent pregnancy by using family planning methods described above. Several kinds of emergency family planning or "morning after" pills are available (such as Plan B, Postinor, and others) but they must be used within 5 days of unprotected sex. See Where Women Have No Doctor.

If a woman decides not to continue a pregnancy, she may choose among 3 different methods of abortion if they are available.

Abortion by medicine: Also called medical abortion, the pregnancy is expelled by the woman after taking the medicine misoprostol alone, or both misoprostal and mifepristone. Since nothing is put inside the womb, there is less danger of infection, but it is still best to be near a clinic in case heavy bleeding occurs.

Abortion by suction: Also called vacuum aspiration or MVA, the pregnancy is removed by putting a special tube (cannula) through the vagina into the cervix and sucking the pregnancy into a type of syringe. It can be done in a clinic or doctor’s office in about 10 minutes.

Abortion by scraping: Also called a D and C, the pregnancy is removed by scraping with a small, sharp, spoon-shaped instrument. It is usually done in an operating room in about 20 minutes, and the woman may be given a medicine to make her sleep.

Unsafe abortions can result in infections, pain, infertility, and sometimes even death. But a safe abortion is less likely to cause harm than having a baby. Safe abortions are done:

  • by a trained and experienced health worker.
  • with proper instruments or medicines.
  • under clean conditions. Anything that goes into the vagina and womb must be sterile (without germs).
  • no more than 3 months after the last monthly bleeding, unless it is done in a hospital with special equipment.

It is often hard for a woman to decide to have an abortion. Women who want or need an abortion should be treated with respect and dignity. Having a list of safe abortion services in your community can help save women’s lives. You can also help reduce the need for abortion services by increasing information about and access to family planning.

Information about sexually transmitted infections (STIs) and other infections of the genitals

Sexually transmitted infections (STIs) are infections passed from one person to another during sex. They affect men, women, and sometimes even their children. Although you can only get pregnant from having sex in the vagina, STIs can be transmitted by many kinds of sex, including oral sex and anal sex. Sometimes you can even get an STI from rubbing your genitals against an infected person’s genitals.

Some infections of the genitals are not STIs and you can learn to recognize the signs. If you are in doubt, get tested right away. A change in the smell, color, or texture of vaginal discharge and itching in or on the vagina can also be signs of a yeast infection or a bacterial infection in the vagina, which may not be sexually transmitted. A yeast infection may go away by itself or by using an antifungal medicine (such as miconazole, nystatin, clotrimazole, or others). See Where Women Have No Doctor. But for a bacterial infection you will need to take antibiotics.

If you have pain or a burning feeling when passing urine, and your urine smells bad, looks cloudy, or has blood or pus in it, you might have a urinary tract infection (UTI), which is not an STI. Drinking lots of water may cure the infection, but if you do not feel better in 2 days you will need an antibiotic (such as cotrimoxazole). See a health worker.

Common signs for STIs are:

  • bad-smelling discharge from the genitals
  • itching genitals
  • painful genitals
  • sores, blisters, warts, rashes, irritation or itching in, on, or near the genitals or anus
  • pain or swelling of the testicles
  • pain during sex
  • pain when peeing
  • pain in the lower abdomen
  • bloody discharge from your genitals

It is also very common to have an STI and have no signs at all. Many women and men have STIs but do not know it. HIV, for example, can be in your body for a long time without causing any symptoms. That is why it is important to be tested regularly, especially if you are having sex without a condom.

These are the most common STIs:

  • Gonorrhea and chlamydia are easy to cure if treated early. Since they have the same signs, if you test positive for one, treat for both.
  • Trichomonas is an itchy STI that often causes no signs in men, even though they can still pass it to others.
  • Syphilis causes painless sores on the genitals. Since these may go away by themselves, it is easy to think you are cured, but the disease continues to spread throughout the body. If untreated, it can lead to serious problems including death.
  • Chancroid causes painful sores on the genitals or anus.
  • Genital herpes causes painful sores on the genitals or in the mouth that come and go. It is a virus that is not curable but there is treatment to feel better. Herpes spreads easily, so do not have sex when you have sores and use a condom every time you have sex.
  • HIV is a very serious STI that, if not managed, can lead to AIDS. See Chapter 30 for HIV signs, management, and prevention.


If you have signs of an STI:

a woman speaking.
If you take a medicine and the signs do not go away, see a health worker. It could be another illness.
  • Treat the infection right away. See a health worker to get the correct antibiotics. Ask for more information to help you prevent STIs. You can also find more information, including medicines for STIs, in Where There Is No Doctor, and Where Women Have No Doctor.
  • Do not wait until you are very ill. Early treatment will prevent serious problems, and prevent the spread of infection to others.
  • Make sure your partner is treated at the same time. If he or she is not treated, your partner can infect you again during sex.
  • Take all the medicine, even if your signs go away. You will not be cured until you have taken the full course of medicine.
  • Practice safer sex. Safer sex means lessening direct contact with your partner’s genitals and body fluids. Use a condom each time you have sex to protect you and your partner from STIs.
  • Get tested for HIV. HIV infection often occurs with other STIs.
Health
Info