SEXUALLY TRASMITTED INFECTIONS (STIs)

Did you know that it’s estimated that undiagnosed STD’s cause infertility, in over 24000 women each year in the US?

Sexually transmitted infections (STIs), also known as venereal disease, are group of infectious diseases that are transferred commonly by sexual activity.

Sexual activity includes; vaginal intercourse, anal sex, kissing, oral-genital contact, and the use of sexual toys, such as vibrators. While usually spread by sex, some STIs can be transmitted by non-sexual contact with donor tissue, blood, breastfeeding, or during childbirth. There are over 30 microorganisms known to spread STIs via sexual contact. These microorganisms can be grouped as bacterial, fungal, viral and parasites. STIs often present with embarrassing symptoms like facial disfiguration due to rashes and lumps, genital pain and less conspicuous symptoms like painful urination and discomfort.

 The term sexually transmitted infection is generally preferred over sexually transmitted disease or venereal disease, as it includes those who do not have symptomatic disease.

 

CAUSE

 The following are some of the most common sexually transmitted infections according to the World Health Organization (WHO)

Other types, grouped according to the causative organism include: 

  • Bacterial STI’s

Chancroid, Lymphogranuloma venereum, Granuloma inguinale, mycoplasmal and ureaplasmal infections

  •  Viral STI’s

Molluscum contagiosum, Viral Hepatitis B.

  • Parasitic STI’s

Scabies, Pediculosis pubis

  •  Fungal STI’s

Candidiasis

 There are other infections that can be transmitted through sexual activity but are not primarily considered STIs. These infections include giardiasis, Shigellosis, salmonellosis, campylobacteriosis, amebiasis, hepatitis (A, B, and C) and cytomegalovirus infection.

TRANSMISSION

  •  Vaginal sex with an infected person
  •  Oral sex with an infected person
  •  Anal sex with an infected person
  •  Genital touching
  •  Kissing or close body contact
  •  From mother to child before or during birth
  •  Breastfeeding
  •  Contaminated medical instruments

 EPIDEMIOLOGY

It is estimated that annually, over 19 million cases of STIs are reported in the United States alone. The worldwide estimates are even higher, with 498 million cases of gonorrhea, syphilis and chlamydia occurring every year. STIs like chancroid and granuloma inguinale are more prevalent in developing countries, with others being restricted to specific regions due to a number of factors, such as high incidence of gonorrhea in Asia (due to poor treatment and decreased cephalosporins, which are a kind of antibiotic).

These infections may be introduced to new regions by individuals returning from high risk locales. A sexually transmitted infection is directly correlated with facilitation of HIV transmission. A 2010 published systemic review revealed, that prevalence of travel associated casual sex (20.4%), as well booming commercial sex trade, particularly in South East Asia, increased the risks of one contracting an STIs. Many tourists may patronize the services of these sex workers, which may likely introduce patrons to a wide variety of STIs, including HIV.

In the US, half of the aforementioned 19 million new cases of STIs occur in young individuals aged 15-24 years. STIs like HIV, have reached global epidemic status, contributing to the deaths of over 35.4 million people since the beginning of its incidence. An additional 108,000 deaths have been reported with STIs other than HIV/AIDS since 2015. Due to the nature of the infections and public concern of mortality rates, STIs are often associated with shame and stigma towards those suffering the disease is fairly common.

SIGNS AND SYMPTOMS

In some cases there are no noticeable symptoms of Sexually Transmitted Diseases. Some people are just carriers of the infection; being able to infect others without displaying symptoms themselves. Symptoms of STDs vary depending on the STD, and the gender of the infected individual.  STD symptoms aren’t always obvious. If you see one or more of the following symptoms or have been exposed to an STD, see a doctor.

In Men:

  • Pain or discomfort during sex
  • Painful urination
  • Sores, lumps, or rashes on or around the penis, testicles, anus, buttocks, thighs, or mouth
  • Unusual discharge or bleeding from the penis
  • Swollen testicles
  • Pain around the anus in homosexuals
  • Fatigue
  • Abdominal symptoms may be present with gay patients who have anal sex.

In Women:

  • Pain or discomfort during sex
  • Painful urination
  • Abdominal pain
  • Sores, lumps, rashes on or around the vagina, anus, buttocks, thighs, or mouth
  • Unusual discharge or bleeding from the vagina
  • Itchiness in or around the vagina
  • Fatigue

DIAGNOSIS/CONFIRMATION

Most cases of STDs are left undiagnosed since patients do not notice any obvious symptoms. STIs cannot be diagnosed based on symptoms only. Laboratory tests are conducted and the medical history of the patient is taken to arrive at a diagnosis.

Some of the tests include:

  • Examination of blood sample
  • Analysis of urine sample
  • Examination sexual organ discharge.

Home testing kits are also available for some STIs, but they may not always be reliable.

Test are done for STIs to identify the cause and choose the most appropriate treatment routine, based on the patient’s symptoms and suspected microorganism involved.

To identify the organism involved and confirm the diagnosis, doctors may take a sample of blood, urine, or discharge from the vagina or penis and examine it. The sample may be sent to a laboratory for the organisms to be cultured (grown in controlled conditions) to aid in identification. Doctors may treat patients after their first visit, before test results become available (which usually takes several days).

If a person has an STI, other tests can be done to exclude other STIs. This is because people who have any STI, have a relatively high chance of having another one.

PREVENTION

The following can help prevent STIs:

  • Abstinence
  • Early diagnosis and treatment of STIs
  • Regular and correct use of condoms
  • Avoidance of unsafe sex practices, such as frequently changing sex partners or having sexual intercourse with prostitutes or with partners who have other sex partners
  • Circumcision
  • Identification of infected people, followed by counseling or treatment of these contacts
  • Vaccination is an option for preventing STIs. However, there are only vaccines available for HPV infection, hepatitis A, and hepatitis B.

 TREATMENT

  • Bacterial STIs

Antibiotics are used to treat bacterial infections.

  •  Viral STIs

Most viral infections have no cure and most will resolve on their own. In many cases, treatment options are available to relieve symptoms and reduce the risk of transmission. STIs caused by parasites are also cured by antibiotics, anti-parasitic drugs or medicated shampoos.

Most STIs are curable through the use of antibiotics or antiviral medications. However, there are still four incurable STIs. Hepatitis B, Herpes, Human Immunodeficiency Virus (HIV) and Human Papillomavirus (HPV) currently have no cure and are all viral(caused by viruses) STIs. Despite their lack of a cure, these infections can be managed with treatment and medication.