Sexually transmitted diseases (STDs) have become a major topic and has risen due to a decline in the practice of safe sex. STDs remain a public health problem in most part of the world. Failure to diagnose and treat STDs at an early stage often results in serious complications and sequelae.
What are sexually transmitted diseases (STDs)
Sexually transmitted diseases (STDs) are infections that can be transferred from one person to another through any type of sexual contact. STDs are sometimes referred to as sexually transmitted infections (STIs) since they involve the transmission of a disease-causing organism from one person to another during sexual activity.
Sometimes these infections can be transmitted non-sexually, such as from mother to infant during pregnancy or childbirth, or through blood transfusions or shared needles.
More than 1 million STIs are acquired every day. In 2016, WHO estimated 376 million new infections with 1 of 4 STIs: chlamydia (127 million), gonorrhoea (87 million), syphilis (6.3 million) and trichomoniasis (156 million). More than 500 million people are living with genital HSV (herpes) infection and an estimated 300 million women have an HPV infection, the primary cause of cervical cancer. An estimated 240 million people are living with chronic hepatitis B globally. Both HPV and hepatitis B infections are preventable with vaccination.
Symptoms of STDs in men
It’s possible to contract an STD without developing symptoms. But some STDs cause obvious symptoms. In men, common symptoms include:
- pain or discomfort during sex or urination
- sores, bumps, or rashes on or around the penis, testicles, anus, buttocks, thighs, or mouth
- unusual discharge or bleeding from the penis
- painful or swollen testicles
Specific symptoms can vary, depending on the STD.
Symptoms of STDs in women
In many cases, STDs don’t cause noticeable symptoms. When they do, common STD symptoms in women include:
- pain or discomfort during sex or urination
- sores, bumps, or rashes on or around the vagina, anus, buttocks, thighs, or mouth
- unusual discharge or bleeding from the vagina
- itchiness in or around the vagina
- lower abdominal pain
The specific symptoms can vary from one STD to another.
Signs and symptoms may appear a few days after exposure, or it may take years before you have any noticeable problems, depending on the organism.
What are the causes of STDs?
Sexually transmitted diseases (STDs) can be caused by:
- Bacteria (gonorrhea, syphilis, chlamydia)
- Parasites (trichomoniasis)
- Viruses (human papillomavirus, genital herpes, HIV)
Sexual activity plays a role in spreading many other kinds of infections, although it’s possible to be infected without sexual contact. Examples include the hepatitis A, B and C viruses, shigella, and Giardia intestinalis.
Risk factors of STDs
Anyone who is sexually active risks some degree of exposure to a sexually transmitted disease (STD) or a sexually transmitted infection (STI). Factors that may increase that risk include:
- Having unprotected sex. Vaginal or anal penetration by an infected partner who isn’t wearing a latex condom significantly increases the risk of getting an STI. Improper or inconsistent use of condoms can also increase your risk.
Oral sex may be less risky, but infections can still be transmitted without a latex condom or a dental dam — a thin, square piece of rubber made with latex or silicone.
- Having sexual contact with multiple partners. The more people you have sexual contact with, the greater your risk. This is true for concurrent partners as well as monogamous consecutive relationships.
- Having a history of STIs. Having one STI makes it much easier for another STI to take hold.
- Anyone forced to have sexual intercourse or sexual activity. Dealing with rape or assault can be difficult, but it’s important to see a doctor as soon as possible so that you can receive screening, treatment and emotional support.
- Misuse of alcohol or use of recreational drugs. Substance misuse can inhibit your judgment, making you more willing to participate in risky behaviors.
- Injecting drugs. Needle sharing spreads many serious infections, including HIV, hepatitis B and hepatitis C.
- Being young. Half the STIs occur in people between the ages of 15 and 24.
STDs from Oral sex
Vaginal and anal sex are not the only way STDs are transmitted. It’s also possible to contract or transmit an STD through oral sex.
By definition, oral sex is when someone puts his or her lips, mouth or tongue on a man’s penis, a woman’s genitals (including the clitoris, vulva, and vaginal opening), or the anus of another person. There are different terms used to describe types of oral sex:
- Fellatio is the technical term used to describe oral contact with the penis.
- Cunnilingus describes oral contact with the clitoris, vulva or vaginal opening.
- Anilingus (sometimes called “rimming”) refers to oral contact with the anus.
As with other types of sexual activity, oral sex carries the risk of STIs. It may be possible to get some STIs in the mouth or throat from giving oral sex to a partner with a genital or anal/rectal infection, particularly from giving fellatio. It also may be possible to get certain STIs on the penis, and possibly the vagina, anus or rectum, from receiving oral sex from a partner with a mouth or throat infection. It’s possible to have an STI in more than one area, for example in the throat and the genitals.
Examples of STDs from oral sex includes:
- Human Simplex virus (types 1 and 2)
- Human papilloma virus (HPV)
- Human immunodeficiency virus (HIV)
STDs and Cancer
There are a number of risk factors for cancer; increasingly of interest to researchers is the link between cancer and viral, bacterial, and parasitic infections. Some sexually transmitted diseases are among those that can increase the risk for developing certain cancers:
- HPV is the primary cause of a number of cancers including those of the cervix, anus, and penis
- Chronic hepatitis B and hepatitis C infections cause liver cancer
- HIV patients are susceptible to several cancers including Kaposi sarcoma, a cancer targeting the lining of blood vessel.
STDs and Pregnancy
Certain STDs — such as gonorrhea, chlamydia, HIV and syphilis — can be passed from an infected mother to her child during pregnancy or delivery. STDs in infants can cause serious problems or even death. All pregnant women should be screened for these infections and treated.
Complications of STDs
Because many people in the early stages of a sexually transmitted disease (STDs) experience no symptoms, screening for STIs is important in preventing complications.
Possible complications include:
- Pelvic pain
- Pregnancy complications
- Eye inflammation
- Pelvic inflammatory disease
- Heart disease
- Certain cancers, such as HPV-associated cervical and rectal cancers.
If your sexual history and current signs and symptoms suggest that you have a sexually transmitted disease (STD) or a sexually transmitted infection (STI), laboratory tests can identify the cause and detect coinfections you might also have.
- Blood tests. Blood tests can confirm the diagnosis of HIV or later stages of syphilis.
- Urine samples. Some STIs can be confirmed with a urine sample.
- Fluid samples. If you have open genital sores, your doctor may test fluid and samples from the sores to diagnose the type of infection.
Testing for a disease in someone who doesn’t have symptoms is called screening. Most of the time, STI screening is not a routine part of health care, but there are exceptions:
- Everyone. The one STI screening test suggested for everyone ages 13 to 64 is a blood or saliva test for human immunodeficiency virus (HIV), the virus that causes AIDS. Experts recommend that people at high risk have an HIV test every year.
- Pregnant women. All pregnant women will generally be screened for HIV, hepatitis B, chlamydia and syphilis at their first prenatal visit. Gonorrhea and hepatitis C screening tests are recommended at least once during pregnancy for women at high risk of these infections.
- Women age 21 and older. The Pap test screens for cervical abnormalities, including inflammation, precancerous changes and cancer, which is often caused by certain strains of human papillomavirus (HPV). Experts recommend that women have a Pap test every three years starting at age 21. After age 30, experts recommend women have an HPV DNA test and a Pap test every five years. A Pap test every three years is also acceptable.
- Men who have sex with men. Compared with other groups, men who have sex with men run a higher risk of acquiring STIs. Many public health groups recommend annual or more-frequent STI screening for these men. Regular tests for HIV, syphilis, chlamydia and gonorrhea are particularly important. Evaluation for hepatitis B also may be recommended.
- People with HIV. If you have HIV, it dramatically raises your risk of catching other STIs. Experts recommend immediate testing for syphilis, gonorrhea, chlamydia and herpes after being diagnosed with HIV. They also recommend that people with HIV be screened for hepatitis C.
Treatment of STDs
Effective treatment is currently available for several STIs.
- Three bacterial STIs (chlamydia, gonorrhoea and syphilis) and one parasitic STI (trichomoniasis) are generally curable with existing, effective single-dose regimens of antibiotics.
- For herpes and HIV, the most effective medications available are antivirals that can modulate the course of the disease, though they cannot cure the disease.
- For hepatitis B, antiviral medications can help to fight the virus and slow damage to the liver.
How You Can Prevent Sexually Transmitted Diseases
- Abstinence: The most reliable way to avoid infection is to not have sex (i.e anal, vaginal or oral).
- Vaccination: Vaccines are safe, effective, and recommended ways to prevent hepatitis B and HPV.
- Reduce Number of Sex Partners: Reducing your number of sex partners can decrease your risk for STDs. It is still important that you and your partner get tested, and that you share your test results with one another.
- Mutual Monogamy: Mutual monogamy means that you agree to be sexually active with only one person, who has agreed to be sexually active only with you. Being in a long-term mutually monogamous relationship with an uninfected partner is one of the most reliable ways to avoid STDs. But you must both be certain you are not infected with STDs. It is important to have an open and honest conversation with your partner.
- Use Condoms: Correct and consistent use of the male latex condom is highly effective in reducing STD transmission. Use a condom every time you have anal, vaginal, or oral sex. It should be noted that other forms of birth control will not prevent you from STDs.
- Put yourself to the test: Knowing your STD status is a critical step to stopping STD transmission. If you know you are infected you can take steps to protect yourself and your partners.
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