STD

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Summary

Sexually transmitted diseases (STDs), also known as sexually transmitted infections (STIs) or venereal diseases (VD), are types of infections caused by microbes. As the name of these conditions suggest, the primary way of contracting any of these STDs is through sexual intercourse.

However, the microbes causing STDs can also spread through the use of needles or syringes previously used by a person with STD. They can also be transmitted through blood transfusion. A pregnant woman with an STD can also pass the condition to her unborn child.

STD-carrying microbes can spread from the affected person to their partner through genital skin contact. These germs can also spread through the mucous membranes of the genitals, semen, vaginal secretions, or even through blood.

How do STDs affect the body?

For women, the common symptoms of STDs include:

• Pain during intercourse or urination
• Sores, lumps, or rashes around the genitals, anus, thighs, and even the mouth
• Unusual discharge or bleeding from the vagina
• Itching inside or around the genitals

For men, the common symptoms of STDs include:

• Pain during intercourse or urination
• Sores, lumps, or rashes around the genitals, testicles, anal area, thighs, and even the mouth
• Unusual discharge or bleeding from the penis
• Pain or swelling of the testicles

History of STDs

Syphilis is one of the most well-known types of STDs, recorded as early as 1494. During this time, it spread among French soldiers during the outbreak of the Italian War. As it spread across Europe, the disease killed over five million people.

Meanwhile, gonorrhea was recorded in Paris about 700 years ago. It became widespread in parts of the country where many sex workers operated.

Before the discovery of modern medicines, diseases that spread through sexual intercourse were incurable, except for their symptoms. One of the first treatment centers for those with STDs was the London Lock Hospital, established in 1746. By the 19th century, the Contagious Diseases Act was developed and used to apprehend suspected sex industry workers to prevent the spread of STDs.

By the 20th century, the first effective medicine against STDs, salvarsan, was invented. It’s used to treat syphilis. With the discovery of antibiotics, even more types of STDs became treatable. Moreover, the spread of STDs was further curtailed with intensified movements against them in the 1960s and 1970s.

Around the same time, the importance of identifying the sexual partners of those affected by STDs was recognized. This was done to test and treat them for any diseases they might carry. As a result, the spread of STDs to the public was further prevented.

However, in the 1980s, herpes and AIDS spread for the first time. Today, we are gradually seeing the emergence of more effective methods to prevent the spread and treat the symptoms of these diseases.

Characteristics

At the outset of an STD, there might be no noticeable symptoms. Even as some of these diseases progress, there may still be no noticeable signs. However, in many cases, the common symptoms of STDs are as follows:

• Having a fever
• Sores or lumps in or around the genitals, mouth, or anus
• Pain or a burning sensation inside or outside the genital area when urinating
• Pain inside or outside the genital area during intercourse
• Discharge from the male genitalia
• Unusual or foul-smelling discharge from the female genitalia
• Abnormal bleeding from the female genitalia
• Swelling and pain in the lymph nodes, especially in the groin area
• Abdominal pain
• Presence of rashes in various parts of the body

These symptoms may appear a few days or even years after being exposed to microorganisms that cause STD. The speed or delay in the onset of symptoms depends on the type of microorganism causing the disease.

Causes

The skin, mucous membranes, blood, or fluids from the genitals or anus of both men and women are the common habitats of STD-causing microorganisms. Therefore, without adequate protection like condoms, a healthy individual can contract an STD through the following methods:

• Performing oral sex on a male by taking the penis in the mouth
• Performing oral sex on a female by licking her genitals
• Engaging in vaginal sex where the male inserts his penis into the female’s vagina
• Engaging in anal sex where the male inserts his penis into the partner’s anus
• Engaging in “analingus” or oral sex in which the anus of the partner is licked

Microorganisms and other organisms causing STDs

There are four types of microorganisms and organisms that can cause STDs: bacteria, fungi, viruses, and parasites.

STDs caused by bacteria include:

• Chancroid (Haemophilus ducreyi)
• Chlamydia (Chlamydia trachomatis)
• Gonorrhea (Neisseria gonorrhoeae)
• Granuloma inguinale (Klebsiella granulomatis)
• Mycoplasma genitalium
• Mycoplasma hominis
• Syphilis (Treponema pallidum)
• Ureaplasma infection

The types of STDs caused by viruses include:

• Herpes simplex
• HIV (Human Immunodeficiency Virus)
• HPV (Human Papillomavirus)
• Molluscum contagiosum (molluscum contagiosum virus or MCV)
• Viral hepatitis (Hepatitis B virus)

There are also types of STDs caused by tiny parasites. These include:

• Crab louse
• Scabies (Sarcoptes scabiei)
• Trichomoniasis (Trichomonas vaginalis)

Candidiasis or yeast infection, on the other hand, is a type of infection in the female genitalia caused by a type of fungus. Although it can be transmitted through intercourse, this is very rare.

Now, what are the factors that can increase the risk of contracting STDs?

Factors that increase the risk of acquiring an STD

All sexually active individuals are exposed to STDs. The factors that increase their risk of acquiring an STD include:

• Engaging in intercourse without protection. Engaging in vaginal or anal intercourse with someone who has an STD without using a condom increases the risk of contracting the disease. Also, improperly using a condom can increase this risk.
• Having multiple sexual partners. Having multiple partners heightens the risk of acquiring an STD. The risk is even higher if those partners are strangers.
• Engaging in oral sex. While the risk of getting an STD from oral sex may not be as high as from other forms of intercourse, the microbes causing these diseases, if present in an affected person’s genitalia, can still be transmitted when they come into contact with a partner’s mouth.
• Having had an STD before. Individuals who have previously had an STD may contract it again or become susceptible to other types of diseases.
• Men who frequently use drugs for erectile dysfunction. Most men who consume drugs for this condition often have a very active sexual life. This elevates the risk of them contracting an STD, especially if they engage in unprotected intercourse.

Other factors that raise the likelihood of contracting an STD include:

• Being young. Over half of those with STDs are aged between 15 to 24 years old.
• Being a victim of abuse. Anyone who has been sexually assaulted or abused might have been exposed to the microbes causing STDs. Thus, it’s advised for victims to seek medical attention immediately to assess their health status.
• Injecting drugs. Drug injection, especially when using dirty or previously used needles, can be a means of spreading HIV or other infections such as hepatitis B and C.
• Abusing intoxicating substances and drugs. Being intoxicated, whether due to alcohol or drugs, can affect one’s judgment. A person who is unable to think clearly because they are drunk or under the influence of drugs might engage in behaviors that put their health at risk.

Treatment and Prevention of STDs

STDs have various causes. Because of this, there are also various ways to treat them. For example, STDs caused by bacteria are treated using antibiotics. Those caused by viruses, like HIV, require specialized treatments.

Here are the commonly used drugs for HIV/AIDS:

Nucleoside Reverse Transcriptase Inhibitors (NRTI). These inhibit the replication of HIV. Examples are:

• Abacavir
• Didanosine (ddl)
• Lamivudine (3TC)
• Stavudine (d4T)
• Zalcitabine (ddC)
• Zidovudine (ZDV)

Protease Inhibitors. These drugs prevent the replication of HIV within the C4 cells. Examples are:

• Indinavir
• Nelfinavir
• Ritonavir
• Saquinavir
• Lopinavir plus ritonavir

For chlamydia, the following antibiotics are used:

• Azithromycin
• Erythromycin
• Doxycycline

Gonorrhea can be treated with the following antibiotics:

• Ceftriaxone
• Cefixime
• Ciprofloxacin
• Ofloxacin

For pelvic inflammatory disease (PID), the following antibiotics are usually prescribed:

• Cefotetan or cefoxitin plus doxycycline
• Clindamycin and gentamicin
• Ofloxacin and metronidazole

STDs resulting from the human papillomavirus (HPV) are treated using topical medications. Some of these drugs include:

• Imiquimod
• Podophyllin
• Podofilox
• Fluorouracil (5-FU)
• Trichloroacetic acid (TCA)
• Interferon

Genital herpes is treated using the following antiviral drugs:

• Acyclovir
• Famciclovir
• Valacyclovir

Meanwhile, syphilis is treated using the antibiotic penicillin.

The next question is: what are the steps one can take to prevent STDs?

Prevention of STDs

There are several effective methods to prevent or reduce the risk of acquiring STDs. These methods include:

• Avoiding intercourse. One of the most effective ways to prevent STDs is abstaining from sex, especially with unfamiliar partners.
• Maintaining a monogamous relationship with someone free of STDs.
• Getting tested. Refrain from any form of intercourse until both you and your potential partner have been tested for STDs.
• Vaccination. Ensure you’re vaccinated against human papillomavirus (HPV) and hepatitis B and C before engaging in intercourse with anyone.
• Use condoms and dental dams. Proper and consistent use of condoms and dental dams can help prevent contact between the skin and mucous membranes. When choosing condoms, make sure they are made of latex and not natural membranes.
• Avoid intoxication. An individual who is intoxicated from alcohol or drugs are more likely to engage in uncontrollable risky behaviors.
• Have open discussions. Before engaging in intercourse, especially with someone new, have an open discussion about safe sexual practices and ensure mutual consent.
• Consider circumcision. If uncircumcised, men should consider circumcision. Studies have shown its efficacy in preventing HIV, and it can also prevent the spread of HPV and genital herpes.
• Consider using PrEP. PrEP, or pre-exposure prophylaxis, involves taking the combined drugs emtricitabine-tenofovir disoproxil fumarate (Truvada). It helps reduce the risk of acquiring STDs, especially HIV, for those at high risk. However, it’s important to note that this method is used based on a doctor’s recommendation.

To further aid in preventing STDs, it’s essential to be familiar with the types of these diseases.

Types of STDs

It’s essential to understand that not all genital infections, especially in women, are transmitted through sexual intercourse, such as some infections caused by fungi. The following are the known types of diseases transmitted through sexual activity:

• Bacterial Vaginosis (BV). This condition is considered the most common genital infection in women, especially those aged 15 to 44. Some of its symptoms include itching and discharge from the genitals with a foul smell. It’s typically treated with antibiotics.
• Chancroid. This disease is a type of infection caused by the bacterium Haemophilus ducreyi. It results in open sores around the genitals of both men and women.
• Granuloma inguinale. This disease is caused by the bacterium Klebsiella granulomatis, previously known as Calymmatobacterium granulomatis. It’s identified by the presence of ulcers on the genitals.
• HIV/AIDS. This highly contagious and deadly disease is caused by the human immunodeficiency virus. It leads to full-blown AIDS where the human immune system completely stops functioning, leaving the victim vulnerable to various life-threatening infections and cancers.
• Hepatitis. This disease causes inflammation of the liver. It’s usually caused by viruses, but it can also be due to other conditions.
• Herpes. This disease affects the genitals and is caused by the herpes simplex virus (HSV). It can remain in the body for several years, showing recurring symptoms such as pain, itching, or genital sores.
• Human Papillomavirus (HPV). This virus causes the most common type of sexually transmitted infection. It usually goes away on its own. However, if neglected, it can cause genital warts or even cancer. This virus can also affect the mouth and throat.
• Chlamydia. This disease is one of the most common types of STDs. It’s caused by the bacterium Chlamydia trachomatis, affecting both men and women. In women, chlamydia can affect the cervix, rectum, or throat. In men, it can appear in the penis, rectum, or throat.
• Genital Warts. This condition involves small warts around the anus or the genital area and is caused by the human papillomavirus.
• Lymphogranuloma venereum (LGV). This disease is a long-term, recurrent infection of the lymphatic system caused by three types of the bacterium Chlamydia trachomatis, which is different from the one causing genital chlamydia.
• Molluscum contagiosum. This skin infection is caused by a virus, resulting in bumps on the skin. These bumps can be as small as a pinhead or as large as a pencil eraser. These bumps are not painful but can become highly contagious if they rupture.
• Mucopurulent Cervicitis (MPC). MPC is a type of STD affecting the cervix. It might be due to chlamydia or gonorrhea, but it can also be caused by other microbes.
• Pelvic Inflammatory Disease (PID). This disease is an infection affecting a woman’s reproductive organs. It occurs when the infection spreads from the genitals to the uterus, fallopian tubes, or ovaries. PID might not show any signs or symptoms.
• Pubic “Crab” Lice. These are tiny parasitic insects that feed on blood. Crab lice infest pubic hair but can also be found in hair on other parts of the body.
• Scabies. This condition affects the skin, causing itching and rashes. It’s caused by a tiny insect called Sarcoptes scabiei. The itching from these insects is a result of an allergic reaction to their eggs and waste that burrow into the skin.
• Syphilis. This disease is caused by the bacterium Treponema pallidum. It can be treated in its early stages. However, if it advances, it can cause various conditions, possibly leading to death. It spreads through sores called “chancres.”
• Trichomoniasis. This disease, caused by a type of parasite, is also known as “trich.” It’s a treatable type of STD. Its symptoms include genital itching, foul-smelling discharge, and pain during urination.
• Gonorrhea. This disease is caused by a type of bacteria that can affect both men and women. It affects the urethra, rectum, and throat. It can also affect the cervix in women.