DISEASES >> SEXUALLY TRANSMITTED DISEASE (STD) OR VENEREAL DISEASE (VD)

Etiology
STDs are caused through sexual contacts like vaginal intercourse, oral sex and anal sex. Other ways in which STD spreads:
  1. Kissing or close body contact—for pubic lice infestation, scabies, and molluscum contagiosum
  2. From mother to child before or during birth—for syphilis, herpes, chlamydial infection, gonorrhea, human immunodeficiency virus (HIV) infection, and human papillomavirus (HPV) infection
  3. Breastfeeding—for HIV infection
  4. Contaminated medical instruments—for HIV infection

Of late, it is being referred as sexually transmitted infection (STI); a person may be infected and might potentially infect others without showing any signs of disease.

Symptoms and Syndromes
Many health care facilities in developing countries lack the equipment and trained personnel required for etiological diagnosis of STIs. To overcome this problem, a syndrome-based approach to the management of STI patients has been developed and promoted.

The term STI refers to the presence an infection which does not necessarily indicate the presence of a disease. The person does not feel sick or notice that something is wrong.

The term STD refers to those infections that have manifested as identifiable diseases, i.e., those that cause symptoms.

Diseases and some of their symptoms follow:

Gonorrhea – burning or frequent urination, a yellowish vaginal discharge, redness and swelling of the genitals, and a burning or itching of the vaginal area.

Chlamydia – cervicitis, vaginal discharge, abdominal pain, women with infection of the urethra (urethritis) have the typical symptoms of a urinary tract infection, including pain upon urination and the frequent and urgent need to urinate.

Chancroid – caused by the bacterium Hemophilus ducreyi, which is passed from one sexual partner to another. It begins in a sexually exposed area of the genital skin, most commonly the penis and vulva (the female external genital organs including the labia, clitoris, and entrance to the vagina).

Genital herpes – during the development period (3 to 7 days) of the lesion, there are no symptoms and the virus cannot be transmitted to others. An outbreak usually begins within two weeks of initial infection and manifests as an itching or tingling sensation followed by redness of the skin. Finally, a blister forms. When the blister breaks, it is painful to touch.

Genital warts – In men, warts usually occur on the penis, especially under the foreskin in uncircumcised men, or in the urethra. In women, genital warts occur on the vulva, vaginal wall, cervix, and skin around the vaginal area. Genital warts may develop in the area around the anus and in the rectum, especially in people who engage in anal sex. Warts cause no symptoms in many people but cause occasional burning pain in some.

Warts may grow more rapidly and spread in pregnant women and in people who have a weakened immune system, such as those who have human immunodeficiency virus (HIV) infection.

Acquired immunodeficiency syndrome – Although there are no specific symptoms or signs that confirm HIV infection, many people will develop a nonspecific illness two to four weeks after they have been infected. This initial illness may be characterized by fever, vomiting, diarrhea, muscle and joint pains, headache, sore throat, and/or painful lymph nodes.

Prevention
The following can prevent STDs:
  1. Avoidance of unsafe sex practices, such as frequently changing sex partners or having sexual intercourse with partners who have other sex partners or prostitutes
  2. Circumcision (which can reduce the spread of HIV from women to men)
  3. Prompt diagnosis and treatment of STDs (to prevent spread to other people)
  4. Identification followed by counseling or treatment of the sexual contacts of infected people
  5. Using vaccines available for protection against some viral STIs: Hepatitis B and some types of human papillomavirus (HPV).
  6. Regular and correct use of condoms – Although condoms do not provide absolute protection from any infection, they greatly reduce the risk of infection.

Treatment
Most STDs can be effectively treated with drugs. However, some new strains of bacteria and viruses, such as HIV, have become resistant to some drugs, making treatment more difficult. As new drugs are developed and more people are treated, resistance to drugs is likely to increase.

People who are being treated for a bacterial STD should abstain from sexual intercourse until the infection has been eliminated from them and their sex partners. Thus, sex partners should be tested and treated simultaneously.
Questions to ask your doctor about sexually transmitted diseases
  1. Does each condition have its own test, or is there one test for several STDs?
  2. What is the percentage of protection is there with condoms?
  3. How do you ask your partner if he/she has been infected?
  4. Should the sexual partners be notified?
  5. How can you tell if the sex partner has STDs?
  6. Could a yeast infection be mistaken for a STD?
  7. How long can a STD stay dormant with no symptoms?
  8. Should testing for HIV be done?
  9. How to prevent future infections and how to have safe sex?

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