Sexually Transmitted Diseases

SEXUALLY TRANSMITTED DISEASES

DEFINITION

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A sexually transmitted disease (STD) is a disease transmitted through sexual contact between two people. They may be transmitted through the exchange of semen, blood, and other body fluids or by direct body contact. The term sexually transmitted disease applies to more than twenty different infections. At one time, these diseases were more commonly referred to as venereal diseases.

DESCRIPTION

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Sexually transmitted diseases are very common medical conditions. In the United States, about 85 percent of the most common infectious diseases can be spread by sexual contact. The rate of STD infection in the United States is more than 50 times as great as that in other developed countries. Experts estimate that 1 in 4 of all sexually active Americans will get an STD at least once in their lives.

About twelve million new STD infections occur in the United States each year with teenagers between the ages of sixteen and nineteen accounting for 1 in 4 cases.

Sexually transmitted diseases are often mild infections that can be cleared up with simple medical treatment. If left untreated, however, serious complications can result. These complications include:

• Birth defects
• Blindness
• Bone deformities
• Cancer
• Heart disease
• Infertility
• Mental retardation
• Death

The majority of these complications develop only when an STD is not treated properly.

Types of STD

The following are some of the more common STDs in the United States.

• Chlamydia. Chlamydial diseases are caused by microscopic organisms that belong to the family chlamydia (pronounced kluh-MID-ee-uh). Two common chlamydial infections are nongonococcal (not gonorrhea) urethritis (NGU) and nonspecific urethritis (NSU). Urethritis (pronounced YOOR-ih-THRY-tiss) means an inflammation of the urethra.
• Gonorrhea. Gonorrhea (pronounced gahn-uh-REE-uh) is caused by a microorganism called Neisseria gonorrhoea (pronounced ny-SEER-ee-uh gahn-UH-ree-uh). It is easily cured when treated properly.
• Genital warts. Genital warts are caused by the human papillomavirus (HPV). It is the single most important risk factor for cervical cancer in women (see cancer entry).
• Syphilis. Syphilis (SIF-uh-liss) is caused by a microorganism called Treponema pallidum (pronounced trep-uh-NEE-muh PAL-ee-um). Like most STDs, syphilis can be cured if treated promptly and correctly. However, when left untreated, it can cause serious damage to the body and even death.
• Human immunodeficiency virus (HIV) infection. HIV is the virus responsible for acquired immunodeficiency syndrome or AIDS (see AIDS entry). No cure is presently available for HIV infection. However, major steps have been made in finding ways to control the disease.

Sexually Transmitted Diseases: Words to Know

Antibiotic:

A substance derived from bacteria or other organisms that fights the growth of other bacteria or organisms.

Chlamydia :

A family of microorganisms that causes several types of sexually transmitted diseases in humans.

Condom:

A thin sheath (covering) worn over the penis during sexual activity to prevent pregnancy and the spread of STD.

Diaphragm:

A dome-shaped device used to cover the back of a woman's vagina to prevent pregnancy.

Gonorrhea:

An STD that affects the mucous membranes, particularly in the urinary tract and genital area. Can make urination painful and cause pus-like discharges through the urinary tract.

Lymph nodes:

Small round or oval bodies within the immune system. Lymph nodes provide materials that fight disease and help remove bacteria and other foreign material from the body.

Monogomy:

When both people in a relationship have no sexual activities outside of the relationship. The practice of having only one sexual partner.

Nongonococcal urethritis (NGU):

An inflammation of the urethra that is not caused by the microorganism that causes gonorrhea.

Nonspecific urethritis (NSU):

An inflammation of the urethra caused by a chlamydia microorganism. The term arose because at one time, the cause of the infection was not known.

Syphilis:

An STD that can cause sores and eventually lead to brain disease, paralysis, and death.

Semen:

A white fluid produced by the male reproductive system that carries sperm.

Vaccine:

A substance that causes the body's immune system to build up resistance to a particular disease.

CAUSES

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STDs are transmitted during sexual activity. Sexual activity often involves the exchange of bodily fluids between two people. These bodily fluids include semen, blood, and saliva. The risk of contracting an STD is low in any sexual activity in which no bodily fluids are exchanged.

During sexual activity, the organisms that cause STDs are passed from an infected person to an uninfected person. Once those organisms enter the healthy person's body, they begin to grow and reproduce. After a certain period of time, enough organisms are present in the body to begin causing the symptoms of the disease.

The period after infection, during which the organisms are developing, is known as the incubation period. The incubation period varies widely for various STDs. For gonorrhea, NGU and NSU, the incubation may be as short as a few days. For HIV infections, the incubation period may be as long as ten years.

EHRLICH'S "MAGIC BULLET"

Syphilis is one of the most terrible diseases known to humans. When the organism that causes the disease (a spirochete ) enters the body, it produces relatively mild symptoms. The spirochete then goes into hibernation for many years. Later in the patient's life, the spirochete becomes active again. It then causes horrible symptoms. The patient may lose control of nervous and muscular functions, often accompanied by severe pain. Eventually severe mental disorders may develop, including insanity. The disease may also cause death.

A cure for syphilis was not available until the early twentieth century. It was found quite by accident. The German bacteriologist Paul Ehrlich was searching for a drug that would kill bacteria that cause disease. He called that drug his "magic bullet."

Ehrlich and his students organized their search for a "magic bullet" in a very systematic way. They made a list of all the chemical compounds they wanted to test. Then they tried each chemical on the list, one at a time.

In 1907, Ehrlich's team had reached compound #606. They found it had no effect on bacteria, so they set it aside. Two years later, one of Ehrlich's assistants decided to test compound #606 on spirochetes. He found that it killed them very effectively. A "magic bullet" for syphilis had been found!

The compound Ehrlich's team discovered contains the element arsenic. Arsenic is a powerful poison. The team named the compound salvarsan.

The symptoms of various STDs vary widely. In some cases, there may be no symptoms at all, but in most cases symptoms develop that are characteristic of a specific form of STD. Common symptoms of STDs include:

• In men, a discharge from the tip of the penis accompanied by pain while urinating
• In women, vaginal itching, burning, and odor, sometimes accompanied by bleeding not associated with menstruation

• In both men and women, swelling of lymph nodes in the groin
• In both men and women, skin rashes, sores, bumps, or blisters near the mouth, the genitals, or the anus
• Fever, chills, and other flu-like symptoms
• Aches and pains in the joints
• Swelling and redness in the throat that lasts for more than three weeks

DIAGNOSIS

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The diagnosis of STDs depends to a large extent on the patient. Teenagers should learn the symptoms of various STDs. When they observe any of these symptoms in their own bodies, they should seek medical attention.

This principle is valuable advice for most diseases and disorders. But it is especially important in the case of STDs. People are often reluctant to talk about personal matters, such as sexual activity. They may prefer to ignore changes they observe in their genital areas or changes they know may be related to sexual activity. But timely treatment can stop STDs from becoming even more serious.

Most STDs are relatively easy to diagnose. The symptoms described above are easy to observe and quite characteristic of sexually transmitted diseases. Many of the diseases can be diagnosed with simple blood tests. The organism that causes the diseases can generally be detected and identified in the patient's blood.

Doctors often test for more than one STD at a time. A person who is infected with syphilis, for example, may also have gonorrhea at the same time.

Notification

Sexually transmitted diseases are regarded as a public health problem. That is, they do not involve a single person alone, but the health of the entire community. A person diagnosed with an STD was infected by someone else and is at risk of transmitting to others.

To cut down on the spread of STDs through a community, many states have reporting laws. These laws require that public health officials find and contact the partners of anyone diagnosed with an STD. The purpose of these laws is to reduce the spread of STDs through the community. In an ideal situation, patients themselves will contact all their partners. To make sure that happens, public health officials usually ask patients for the names and addresses of those partners. They then follow up with interviews to let those partners know that they may also be infected with an STD.

TREATMENT

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All forms of STD should be treated by a medical professional. The type of treatment used differs from infection to infection. In some cases, antibiotics can cure a disease quickly and efficiently. (Antibiotics are substances derived from bacteria or other organisms that fight the growth of other bacteria or organisms.) The standard treatment for syphilis, gonorrhea, and chlamydial infections, for example, is a single injection of the common antibiotic penicillin or a series of pills.

Viral infections, like HIV infection and genital herpes, are more difficult to treat. There are not many effective medications for the treatment of viral infections.

PROGNOSIS

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The prognosis for recovery from STDs varies from disease to disease. When properly treated in their earliest stages, many can be cured completely in a short period of time. Gonorrhea, NGU, NSU, and syphilis fall into this category.

In other cases, such as HIV infections, no cure is currently available. However, treatments are available to relieve the symptoms of non-curable STDs and to reduce the risk of serious complications.

PREVENTION

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Sexually transmitted diseases can be prevented in a number of ways, including the use of vaccinations, lifestyle choices, safer sex practices, and hygienic measures.

Vaccines

Vaccines have been developed for a few STDs, such as hepatitis A and hepatitis B. A vaccine (pronounced vak-SEEN) is a material that that causes the body's immune system to build up resistance to a particular disease. Individuals at risk for these infections should be vaccinated against them. Researchers are continually looking for vaccines against other sexually transmitted diseases.

Lifestyle Choices

The risk of contracting a sexually transmitted disease is very much related to choices one makes about one's sexual activity. Abstinence (avoiding sexual activity altogether) may be the best method of avoiding STDs.

In general, the larger the number of sexual partners a person has, the greater the risk he or she has of contracting an STD. Among sexually active people, the risk of contracting an infection is lowest for those who are in monogamous (pronounced muh-NOG-uh-muss) relationships (couples who have no sexual partners outside of their relationship).

It is also important to know the health status of a prospective sexual partner. Sexual activity with prostitutes or anonymous partners increases the risk of contracting STD. Discussing one's sexual health with a prospective partner is an important health precaution.

One can also choose to take part or not take part in intravenous drug use. Intravenous drug use often involves sharing needles with other people who may be infected with an STD. Some sexually transmitted infections are easily spread in blood passed from one person to another.

Use of Condoms and Other Contraceptives

The term safer sex is used to describe a number of techniques that can be used during sexual activity to avoid contracting an STD. The concept is that sexual activity can be both pleasurable and safe by taking a few simple precautions.

Perhaps the most effective precaution one can use during sexual activity is a condom. When properly used, a condom is very effective in preventing the transmission of bodily fluids from one person to another.

Spermicides (substances that kill sperm) and diaphragms are also somewhat effective in preventing the spread of STDs. But they are not totally effective and do not prevent the spread of some organisms, such as HIV. Either or both of these, when used with a condom, can decrease the chance of spreading and STD.

Hygienic Measures

Cleanliness is always an important factor in avoiding the spread of any disease. However, careful washing alone is not very effective against most organisms that cause STDs. The organisms are often able to penetrate far up into the body, where they will not be affected by soap and water.

See also: AIDS, and Herpes infections.

FOR MORE INFORMATION

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Books

Dudley, William, ed. Sexually Transmitted Diseases. San Diego: Greenhaven Press, 1999.

Marr, Lisa. Sexually Transmitted Diseases: A Physician Tells You What You Need to Know. Baltimore: Johns Hopkins University Press, 1999.

Woods, Samuel G., and Ruth C. Rosen, eds. Everything You Need to Know about STD. New York: Rosen Publishing Group, 1997.

Organizations

Planned Parenthood Federation of America. 810 Seventh Ave. New York, NY 10019 (800) 230–7526. http://www.plannedparenthood.org.

National STD Hotline. (800) 227–8922.

Web sites

"Ask NOAH About: Sexually Transmitted Diseases." NOAH: New York Online Access to Health. [Online] http://www.noah.cuny.edu/stds/stds.html (accessed on October 31, 1999).

"Basic Facts about STDs." [Online] http://www.mcare.org/healthtips/homecare/basicfac.htm (accessed on May 23, 1998).

"Can STDs Be Prevented?" [Online] http://housecall.orbisnews.com/sponsors/asfp/topics/infections_d/stds/page5.html (accessed on May 23, 1998).

"1998 Guidelines for Treatment of Sexually Transmitted Disease." [Online] http://www.cdc.gov/nchstp/dstd/STD98T03.htm (accessed on May 23, 1998).

"The Challenge of STD Prevention in the United States." [Online] http://www.cdc.gov/nch.stp.dstd/STD_Prevention_in_the_United_States.htm (accessed on May 23, 1998).