STD!!!Sexually transmitted diseases Definition Sexually transmitted disease (STD) is a term used to describe more than 20 different infections that are transmitted through exchange of semen, blood, and other body fluids; or by direct contact with the affected body areas of people with STDs. Sexually transmitted diseases are also called venereal diseases. Description The Centers for Disease Control and Prevention (CDC) has reported that 85% of the most prevalent infectious diseases in the United States are sexually transmitted. The rate of STDs in this country is 50 to 100 times higher than that of any other industrialized nation. One in four sexually active Americans will be affected by an STD at some time in his or her life. About 12 million new STD infections occur in the United States each year. One in four occurs in someone between the ages of 16 and 19. Almost 65% of all STD infections affect people under the age of 25. Types of STDs STDs can have very painful long-term consequences as well as immediate health problems. They can cause: • birth defects • blindness • bone deformities • brain damage • cancer • heart disease • infertility and other abnormalities of the reproductive system • mental retardation • death Some of the most common and potentially serious STDs in the United States include: • Chlamydia. This STD is caused by the bacterium Chlamydia trachomatis, a microscopic organism that lives as a parasite inside human cells. Although over 526,000 cases of chlamydia were reported in the United States in 1997, the CDC estimates that nearly three million cases occur annually because 75% of women and 50% of men show no symptoms of the disease after infection. Approximately 40% of women will develop pelvic inflammatory disease (PID) as a result of chlamydia infection, a leading cause of infertility. • Human papillomavirus (HPV). HPV causes genital warts and is the single most important risk factor for cervical cancer in women. Over 100 types of HPV exist, but only about 30 of them can cause genital warts and are spread through sexual contact. In some instances, warts are passed from mother to child during childbirth, leading to a potentially life-threatening condition for newborns in which warts develop in the throat (laryngeal papillomatosis). • Genital herpes. Herpes is an incurable viral infection thought to be one of the most common STDs in this country. It is caused by one of two types of herpes simplex viruses: HSV-1 (commonly causing oral herpes) or HSV-2 (usually causing genital herpes). The CDC estimates that 45 million Americans (one out of every five individuals 12 years of age or older) are infected with HSV-2; this number has increased 30% since the 1970s. HSV-2 infection is more common in women (one out of every four women) than men (one out of every five men) and in African Americans (45.9%) than Caucasians (17.6%). • Gonorrhea. The bacterium Neisseria gonorrhoeae is the causative agent of gonorrhea and can be spread by vaginal, oral, or anal contact. The CDC reports that approximately 650,000 individuals are infected with gonorrhea each year in the United States, with 132.2 infections per 100,000 individuals occurring in 1999. Approximately 75% of American gonorrhea infections occur in persons aged 15 to 29 years old. In 1999, 75% of reported gonorrhea cases occurred among African Americans. • Syphilis. Syphilis is a potentially life-threatening infection that increases the likelihood of acquiring or transmitting HIV. In 1998, the CDC reported approximately 38,000 cases of syphilis in the United States; this included 800 cases of congenital syphilis. Congenital syphilis causes irreversible health problems or death in as many as 40% of all live babies born to women with untreated syphilis. • Human immunodeficiencyvirus (HIV) infection. In 2000, the CDC reported that 120,223 people in the United States are HIV-positive and 426,350 are living with AIDS. In addition, approximately 1,000-2,000 children are born each year with HIV infection. It is also estimated that 33 million adults and 1.3 million children worldwide were living with HIV/AIDS as of 1999 with 5.4 million being newly infected that year. There is no cure for this STD. Social groups and STDs STDs affect certain population groups more severely than others. Women, young people, and members of minority groups are particularly affected. Women in any age bracket are more likely than men to develop medical complications related to STDs. With respect to racial and ethnic categories, the incidence of syphilis is 60 times higher among African Americans than among Caucasians, and four times higher in Hispanics than in Anglos. According to the CDC, in 1999 African Americans accounted for 77% of the total number of gonorrhea cases and nearly 46% of all genital herpes cases. Causes and symptoms The symptoms of STDs vary somewhat according to the disease agent (virus or bacterium), the sex of the patient, and the body systems affected. The symptoms of some STDs are easy to identify; others produce infections that may either go unnoticed for some time or are easy to confuse with other diseases. Syphilis in particular can be confused with disorders ranging from infectious mononucleosis to allergic reactions to prescription medications. In addition, the incubation period of STDs varies. Some produce symptoms close enough to the time of sexual contact-often less than 48 hours later%mdash;for the patient to recognize the connection between the behavior and the symptoms. Others have a longer incubation period, so that the patient may not recognize the early symptoms as those of a sexually transmitted infection. Some symptoms of STDs affect the genitals and reproductive organs: • A woman who has an STD may bleed when she is not menstruating or has abnormal vaginal discharge. Vaginal burning, itching, and odor are common, and she may experience pain in her pelvic area while having sex • A discharge from the tip of the penis may be a sign that a man has an STD. Males may also have painful or burning sensations when they urinate. • There may be swelling of the lymph nodes near the groin area. • Both men and women may develop skin rashes, sores, bumps, or blisters near the mouth or genitals. Homosexual men frequently develop these symptoms in the area around the anus. Other symptoms of STDs are systemic, which means that they affect the body as a whole. These symptoms may include: • fever, chills, and similar flu-like symptoms • skin rashes over large parts of the body • arthritis-like pains or aching in the joints • throat swelling and redness that lasts for three weeks or longer Diagnosis A sexually active person who has symptoms of an STD or who has had an STD or symptoms of infection should be examined without delay by one of the following health care professionals: • a specialist in women’s health (gynecologist) • a specialist in disorders of the urinary tract and the male sexual organs (urologist) • a family physician • a nurse practitioner • a specialist in skin disorders (dermatologist). The diagnostic process begins with a thorough physical examination and a detailed medical history that documents the patient’s sexual history and assesses the risk of infection. The doctor or other healthcare professional will: • Describe the testing process. This includes all blood tests and other tests that may be relevant to the specific infection. • Explain the meaning of the test results. • Provide the patient with information regarding high-risk behaviors and any necessary treatments or procedures. The doctor may suggest that a patient diagnosed with one STD be tested for others, as its possible to have more than one STD at a time. One infection may hide the symptoms of another or create a climate that fosters its growth. At present, it is particularly important that persons who are HIV-positive be tested for syphilis as well. Notification The law in most parts of the United States requires public health officials to trace and contact the partners of persons with STDs. Minors, however, can get treatment without their parents’ permission. Public health departments in most states can provide information about STD clinic locations; Planned Parenthood facilities provide testing and counseling. These agencies can also help with or assume the responsibility of notifying sexual partners who must be tested and may require treatment. Treatment Although self-care can relieve some of the pain of genital herpes or genital warts that has recurred after being diagnosed and treated by a physician, other STD symptoms require immediate medical attention. Antibiotics are prescribed to treat gonorrhea, chlamydia, syphilis, and other STDs caused by bacteria. Although prompt diagnosis and early treatment almost always cures these STDs, new infections can develop if exposure continues or is renewed.Viral infections can be treated symptomatically with antiviral medications. Prognosis The prognosis for recovery from STDs varies among the different diseases. The prognosis for recovery from gonorrhea, syphilis, and other STDs caused by bacteria is generally good, provided that the disease is diagnosed early and treated promptly. Untreated syphilis in particular can lead to long-term complications and disability. Viral STDs (genital herpes, genital warts, HIV) cannot be cured but must be treated on a long-term basis to relieve symptoms and prevent life-threatening complications. Prevention Vaccines Vaccines for the prevention of hepatitis A and hepatitis B are currently recommended for gay and bisexual men, users of illegal drugs, health care workers, and others at risk of contracting these diseases. Vaccines to prevent other STDs are being tested and may be available within several years. Lifestyle choices The risk of becoming infected with an STD can be reduced or eliminated by changing certain personal behaviors. Abstaining from sexual relations or maintaining a mutually monogamous relationship with a partner are legitimate options. It is also wise to avoid sexual contact with partners who are known to be infected with an STD, whose health status is unknown, who abuse drugs, or who are involved in prostitution. Use of condoms and other contraceptives Men or women who have sex with a partner of known (or unsure) infection should make sure a new condom is used every time they have genital, oral, or anal contact. Used correctly and consistently, male condoms provide good protection against HIV and other STDs such as gonorrhea, chlamydia, and syphilis. Female condoms (lubricated sheaths inserted into the vagina) have also been shown to be effective in preventing HIV and other STDs. Condoms provide a measure of protection against genital herpes, genital warts, and hepatitis B. Spermicides and diaphragms can decrease the risk of transmission of some STDs. They do not protect women from contracting HIV. Birth-control pills, patches, or injections do not prevent STDs. Neither do surgical sterilization or hysterectomy. Hygienic measures Urinating and washing the genital area with soap and water immediately after having sex may eliminate some germs before they cause infection. Douching, however, can spread infection deeper into the womb. It may also increase a woman’s risk of developing pelvic inflammatory disease (PID). Key Terms Chlamydia A microorganism that resembles certain types of bacteria and causes several sexually transmitted diseases in humans. Condom A thin sheath worn over the penis during sexual intercourse to prevent pregnancy or the transmission of STDs. There are also female condoms. Diaphragm A dome-shaped device used to cover the back of a woman’s vagina during intercourse in order to prevent pregnancy. Pelvic inflammatory disease (PID) An inflammation of the tubes leading from a woman’s ovaries to the uterus (the Fallopian tubes), caused by a bacterial infection. PID is a leading cause of fertility problems in women. Venereal disease Another term for sexually transmitted disease.
