Sexually transmitted disease

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Sexually transmitted disease

Sexually transmitted diseases (STDs) — also known as sexually transmissible diseases, sexually transmitted infections (STIs), venereal diseases (VD), or infrequently, social disease — are diseases or infections that have a significant probability of transmission between humans through sexual contact, vaginal intercourse, oral sex, or anal sex. Some STIs can also be transmitted through birth, IV needles, or breastfeeding. Additionally, transmission can occur from one male to another through the anal passageway (not as common).

Classification and terminology

Until the 1990s, such afflictions were commonly known as venereal diseases: Veneris is the Latin genitive (possessive) form of the name Venus, the Roman goddess of love. More recently, public health officials have introduced newer terms such as sexually transmitted disease to improve the clarity of their warnings to the public. Moreover, clinicians are increasingly using the term sexually transmitted infection and sometimes distinguish it from sexually transmitted disease. According to http://www.etharc.org:

"Sometimes the terms STI and STD are used interchangeably. This can be confusing and not always accurate, so it helps first to understand the difference between infection and disease. Infection simply means that a germ – virus, bacteria, or parasite – that can cause disease or sickness is present inside a person’s body. An infected person does not necessarily have any symptoms or signs that the virus or bacteria is actually hurting their body (they do not necessarily feel sick). A disease means that the infection is actually causing the infected person to feel sick, or to notice something is wrong. For this reason, the term STI – which refers to infection with any germ that can cause an STD, even if the infected person has no symptoms – is a much broader term than STD."

The distinction being made, however, is closer to that between a colonization and an infection, rather than between an infection and a disease.

Specifically, the term STD refers only to infections that are causing symptoms or problems. Most of the time, people do not know they are infected with an STD until they begin showing symptoms of the disease; therefore, many use the term STD, even though the term STI is also appropriate in many cases.

Moreover, the term sexually transmissible disease is sometimes used since it is less restrictive in consideration of other factors or means of transmission. For instance, meningitis is transmissible by means of sexual contact but is not labeled as an STI because sexual contact is not the primary vector for the pathogens that cause meningitis. This discrepancy is addressed by the probability of infection by means other than sexual contact. In general, an STI is an infection that has a negligible probability of transmission by means other than sexual contact, but has a realistic means of transmission by sexual contact (more sophisticated means - blood transfusion, sharing of hypodermic needles are not taken into account). Thus, one may presume that, if a person is infected with an STI (e.g., chlamydia, gonorrhea, genital herpes), it was transmitted to him/her by means of sexual contact.

Pathology

Many STIs are more easily transmitted through the mucous membranes of the penis, vulva, and less often the mouth. The visible membrane covering the head of the penis is a mucous membrane, although it produces no mucus, similar to the lips of the mouth. Mucous membranes differ from skin in that they allow certain pathogens to enter the body.

This is one reason why the probability of transmitting many infections is far higher through sex than through more casual means of transmission, such as non-sexual contact - touching, hugging, or shaking hands - but it is not the only reason. Although mucous membranes exist in the mouth as they do in the genitals, many STIs appear to be easier to transmit through oral sex than through deep kissing. According to this chart [1], many infections that can be easily transmitted from the mouth to the genitals or from the genitals to the mouth are significantly harder to transmit from one mouth to another. With HIV, genital fluids contain much more of the pathogen than saliva. Some infections identified as STIs can be transmitted by direct skin contact. Herpes simplex and HPV[2] are both examples.

Depending on the STD, a person may still be able to spread the infection even if no signs of the disease are present. For example, a person is much more likely to transmit a herpes infection when blisters are present than when they are absent. However, a person can spread HIV infection at any time, even if he or she has not developed symptoms of AIDS.

All sexual behaviors that involve contact with another person or the bodily fluids of another person should be considered to contain some risk of transmission of sexually transmitted diseases. Most attention has focused on controlling HIV, which causes AIDS, but each STD presents a different situation.

As may be noted from the name, sexually transmitted diseases are transmitted from one person to another by certain sexual activities rather than being actually caused by those sexual activities. Bacteria, fungi, protozoa or viruses are still the causative agents. It is not possible to catch any sexually transmitted disease from sexual activity with a person who is not carrying a disease; conversely, a person who has an STD got it from contact (sexual or otherwise) with someone who had it, or his/her bodily fluids. Some STDs such as HIV can be transmitted from mother to child either during pregnancy or breastfeeding.

Although the likelihood of transmitting various diseases through different sexual activities varies significantly, in general, all sexual activities between two (or more) people should be regarded as a two-way route for the transmission of STDs (i.e. "giving" or "receiving" are both risky).

Healthcare professionals suggest safer sex, such as the use of condoms, as the most reliable way of decreasing the risk of contracting sexually transmitted diseases during sexual activity, but safer sex should by no means be considered an absolute safeguard. Abstinence from sexual activities involving other people will protect against the sexual transmission of sexually transmitted infections. The transfer of and exposure to bodily fluids, such as blood transfusions and other blood products, sharing injection needles, needle-stick injuries (when medical staff is inadvertently jabbed or pricked with needles during medical procedures), sharing tattoo needles, and childbirth are other avenues of transmission. These different means put certain groups, such as doctors, hemophiliacs, and drug users, particularly at risk.

Recent epidemiological studies have examined the networks defined by sexual relationships between individuals and discovered that the properties of sexual networks are crucial to the spread of sexually transmitted diseases. In particular, assortative mixing among people with large numbers of sexual partners appears to be an important factor.

It is possible to be an asymptomatic carrier of sexually transmitted diseases. In particular, sexually transmitted diseases in women often cause the serious condition of pelvic inflammatory disease[3].

Prevalence

STD incidence rates remain high in most of the world, despite diagnostic and therapeutic advances that can quickly render patients with many STDs noninfectious and cure most. In many cultures, shifting sexual mores and the use of oral contraceptives have eliminated traditional sexual restraints, particularly for women, and both physicians and patients struggle to discuss sexual issues openly and candidly. Funding for STD control is almost uniformly inadequate. Additionally, the worldwide spread of drug-resistant bacteria (e.g., penicillin-resistant gonococci) highlights the misuse of antibiotics and the proliferation of resistant clones among mobile populations. The impact of travel is most dramatically illustrated by the rapid spread of the AIDS virus (HIV-1) from Africa to Europe and the Americas in the late 1970s. [4].

Commonly reported prevalences of STIs among sexually active adolescent girls both with and without lower genital tract symptoms to include chlamydia trachomatis (10 to 25%), Neisseria gonorrhoeae (3 to 18%), syphilis (0 to 3%), Trichomonas vaginalis (8 to 16%), and herpes simplex virus (2 to 12%). Among adolescent boys with no symptoms of urethritis, isolation rates include C. trachomatis (9 to 11%) and N. gonorrhoeae (2 to 3%).

As early as 1996, the World Health Organization (WHO) estimated that more than 1 million people were being infected daily. About 60% of these infections occur in young people under 25 years of age, and 30% of this age group is under 20 years. Between the ages of 14 and 19, STDs occur more frequently in girls than in boys at a ratio of nearly 2:1; this equalizes by age 20.

Management

The most effective way to prevent sexual transmission of STIs is to avoid sexual intercourse with an infected partner. Ideally, both new partners should get tested for STIs before initiating sexual intercourse. If a person chooses to have sexual intercourse with a partner whose infection status is unknown or who is infected with HIV or another STI, a new condom should be used for each act of intercourse. Condom use will not completely protect against the acquisition of STI because of the presence of pathogens outside the protected skin or condom breakage.

Treatment

Sexually transmitted diseases have been well-known for hundreds of years - the English language has short words for two of the most common: the "pox" (syphilis) and "the clap" (gonorrhea).

Prior to the invention of modern medicines, sexually transmitted diseases were generally incurable, and treatment was limited to treating the symptoms of the disease. The first voluntary hospital for venereal diseases was founded in 1746 at London Lock Hospital. AIM25 London Lock Hospital records</ref>

The first effective treatment for a sexually transmitted disease was [5]], a treatment for syphilis. With the discovery of antibiotics, a large number of sexually transmitted diseases became easily curable, and this, combined with effective public health campaigns against STDs, led to a public perception during the 1960s and 1970s that they have ceased to be a serious medical threat.

During this period, the significance of contact tracing in managing STIs was acknowledged. By tracing the sexual partners of infected individuals, testing them for infections, treating those who are infected, and subsequently tracing their contacts, STI clinics could effectively suppress infections within the general population.

In the 1980s, first genital herpes and then AIDS emerged into the public consciousness as sexually transmitted diseases that could not be cured by modern medicine. AIDS, in particular, has a long asymptomatic period- during which HIV (the human immunodeficiency virus, which causes AIDS) can replicate, and the disease can be transmitted to others- followed by a symptomatic period that leads rapidly to death unless treated. Recognition that AIDS threatened a global pandemic led to public information campaigns and the development of treatments that allow AIDS to be managed by suppressing the replication of HIV for as long as possible. Contact tracing continues to be an important measure, even when diseases are incurable, as it helps to contain the infection.

Current STD Treatment (Cure)

Types and their pathogenic causes

Most diseases on this list are primarily transmitted sexually. Some can be transmitted in other ways as well; for instance, HIV/AIDS is also often spread through the sharing of infected needles among drug users, while SARS, which can spread through casual contact like coughing and sneezing, is frequently not associated with sexual activity.

Bacterial

Viral

and the route of transmission of [[ Wikipedia:Hepatitis ]] is uncertain, but may include sexual transmission.

Parasites

Protozoal

Sexually transmitted enteric Infections

Various bacterial ([[ Wikipedia:Shigella ]], Campylobacter, or [[ Wikipedia:Salmonella ]]), viral (hepatitis A), or parasitic (Giardia or ameba) pathogens are transmitted by sexual practices that promote anal-oral contamination. Although the bacterial pathogens may coexist with or cause proctitis, they usually produce symptoms (diarrhoea, fever, bloating, nausea, and abdominal pain) suggesting disease more proximal in the GI tract.

See also

References

External links

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