Sexually Transmitted Diseases (What is STD?)

Sexually Transmitted Diseases (What is STD?)

Sexually transmitted diseases (STDs) are diseases that usually are or can be transmitted from person to person, or to another heterosexual or homosexual through intercourse or intimate contact with the genitalia, mouth or rectum. Until the 1980s, only five venereal diseases (syphilis, chancoir, lymphogranuloma venereum, and granuloma inguinale) were monitored. In the 1980s diseases such as Chlamydia trachomatis, human papilloma virus, genital herpes, cytomegalovirus, hepatitis B, genital mycoplasmas, enteric infections, vaginitis, and ectoparasitic disease were included in the list. In addition, many of the newly recognized STDs have become epidemic or hyperendemic as a consequence of changing sexual behavioral patterns. Not only has the incidence of many STDs increased, but also, for agents with multiple modes of transmission (e.g., hepatitis B virus, enteric pathogens), the proportion of infections that are transmitted sexually have increased. In addition to the immediate consequences of STDs there are the recognized effects on maternal and infant morbidity as well as on human reproduction and fertility.

The true incidence of STDs is not known due to variable reporting requirements because many cases are not reported by the clinicians who treat them. The most serious complications are pelvic inflammatory disease (PID), ectopic pregnancy, and sterility, cancer associated with the human papillomavirus, blindness, birth defects, fetal and infant deaths, and mental retardation. The proportions of the population most affected are medically undeserved persons, poor persons, and racial and ethnic minorities.

Sexual Transmission

The STD is a contagious disease spread almost exclusively by contact during sexual intercourse; that is, when mucous membrane surfaces come in contact during genital, oral, or anal sexual activity. Because the causative organisms survive only very briefly outside a warm, moist environment, there is almost no way to contract STDs from toilet seats, towels, or bed linens. Although STD is not usually transmitted in public restrooms, conditions caused by bacteria, virus, fungi, and lice can be transmitted from water in an unclean toilet bowls. Women using a conventional toilet expose the vaginal and anal area to pathogens that can be introduced by the back splash of contaminated toilet water.

There are some notable exceptions to sexually transmission. During pregnancy the fetus may become infected in utero by placental transmission, and the infant may acquire congenital syphilis or be stillborn. Infants of mothers with gonorrhea may contract an infection of the eyes (opthalmia neonatorum) during birth, and unless treated, it can lead to permanent blindness.

Prevention and Health Education

Prevention and control measures for STDs include three levels of prevention. Primary prevention is directed at preventing the disease. This includes educating uninfected persons so that they can take responsibility for their own health and not expose themselves to an infected person; identification and treatment of exposed persons who are asymptomatic; interviewing individuals with infection for identification of contacts; educational programs for the public; and active involvement of professionals in programs of control. The goal of these efforts includes eradication of the reservoir of disease in the population. Secondary prevention is aimed toward prevention of complications. Tertiary prevention is focused on the following; (a) prevention of complication, (b) supporting and counseling of infected persons to receive treatment, and (c) asking infected persons to notify their sexual partners so that they can be examined and treated if infected.