Sexually Transmitted Diseases (STDs)

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Introduction

Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) are conditions that can be transmitted through semen, blood, vaginal fluids, and other body fluids from one person to another. These illnesses can be passed from one person to another via sexual activities (vaginal, oral, or anal). Additionally, it can be transmitted through shared needles, blood transfusions, breastfeeding, or from an infected mother to her unborn child during pregnancy and childbirth. Because many people with STDs do not even know they are infected with it, the disease spreads very easily to their partners.

STIs are one of the most significant global public health issues, affecting both high- and low-income nations.
The lower average age of those having sexual relations, the inconsistent use of condoms, and other changes in sexual habits are mostly to blame for the rise in STIs globally.
All people are susceptible to STIs, but they can be avoided with adequate knowledge and barrier management.
Sexually transmitted illnesses come in many different forms, such as the human papillomavirus (HPV), HIV, genital herpes, chlamydia, gonorrhea, and syphilis.
Some STIs can result in long-term health issues if they are not treated.

Incidence

With 2.5 million or more STD cases anticipated when the full statistics for 2022 are released, the overall rate of STIs in the US is generally rising.
The World Health Organization (WHO) reports that over 1 million potentially treatable STIs are acquired every day throughout the world, the majority of which are asymptomatic.
Each year, an estimated 376 million new cases of one of the four STIs that can be cured (chlamydia, gonorrhea, syphilis, and trichomoniasis) are reported.
Trichomonas, which causes 156 million new cases a year, is the most prevalent of these, followed by chlamydia (127 million), gonorrhea (87 million), and syphilis (6.3 million).
The incidence is increasing between 2015 and 2019, and the number of STIs that were reported in the US increased by almost 30%.
In the United States, it is thought that 12% of people between the ages of 14 and 49 have herpes.
An estimated one million expectant women had an STI in 2016, which resulted in approximately 350,000 problems during labor and/or delivery.
Each year, more than 310,000 deaths from cervical cancer are attributed to HPV infections.
The second-most common reason for stillbirths worldwide is syphilis.
About 37 million people were affected by HIV/AIDS in the world in 2016.
The CDC estimates that 35,000 new HIV cases are diagnosed in the US each year.

Causes of Sexually Transmitted Diseases

Bacteria – It can be the cause of STDs or STIs. Examples of STIs caused by bacteria include gonorrhea, syphilis, and chlamydia.
Parasites – A parasite is the cause of the STI trichomoniasis and crabs.
Viruses – HPV, genital herpes, and HIV are examples of STIs brought on by viruses.

Although it is possible to contract an infection without engaging in sexual activity, other infections, such as the hepatitis A, hepatitis B, and hepatitis C viruses, shigella infection, and giardia infection, can spread through sexual activity.

Types of Sexually Transmitted Diseases

Chlamydia

Chlamydia is a most common STD caused by a bacterium called Chlamydia trachomatis which is mostly asymptomatic.
It spreads through sex with an infected person or contact with infected genital fluids (semen or vaginal fluids).
It can be easily treated with antibiotics. If it remains untreated, it may lead to major health issues like infertility, ectopic pregnancy, etc.
Safe sex practice using condoms and dental dams every time is the best way to prevent chlamydia.

Syphilis

Syphilis is another common STD caused by the bacterium Treponema pallidum.
Typically, there are four stages.
- Early (primary) stage: A person may experience a circular, firm sore at the infection site in the early stages, which is typically around the genitalia, anus, rectum, or mouth. This often lasts three to six weeks.
- Secondary stage: There may be lesions in the mucous membranes, such as the mouth, vagina, or anus, a non-itchy rash of rough, brownish, or red spots on the palms of the hands or soles of the feet, enlarged lymph nodes, hair loss, muscular aches, weight loss, headaches, lethargy, and fever
- Latent stage: While the symptoms vanish during the latent stage, the germs are still present in the body and can still harm it.
- Tertiary stage: Life-threatening problems can affect the brain, neurological system, eyes, heart, and several other organs in the tertiary stage. The body area affected by syphilis will determine the symptoms at this stage.
It is mostly spread through sexual contact. A baby may get congenital syphilis from the mother during pregnancy or at birth.
Antibiotics can treat syphilis effectively.
Early treatment is essential to avoid long-term consequences and lasting harm from this potentially deadly infection.

Gonorrhea

The bacteria Neisseria gonorrhoeae causes the widespread infection known as gonorrhea.
Most of the time, there are no symptoms; however, if any do appear, they may include discharge, period-related bleeding, and genital edema
If it affects the rectum, it may cause anal itching, bowel movement pain, and discharge.
Gonorrhea can also cause pink eye if a person contacts a part of their body that is infected and then touches their eye.
The spread of gonorrhea can occur during anal, vaginal, or oral intercourse.
Antibiotics can be used to treat gonorrhea. Without treatment, HPV can cause life-threatening consequences and is very contagious

Human papillomavirus (HPV) infection

Human papillomavirus (HPV) infection is a common sexually transmitted disease caused by the human papillomavirus
Most people who acquire HPV infection are asymptomatic.
HPV infection can be transmitted via sexual contact and perinatal transmission (mother to baby).
The virus cannot be eradicated through treatment. However, the body’s immune system eliminates the HPV within two years in most cases.
It is a vaccine -preventable infection.
HPV infection increases the risk of cancer of the cervix, vagina, penis, anus, mouth, tonsils, etc.

Genital herpes

Genital herpes is caused by the herpes simplex virus characterized by fluid-filled, painful, small blisters around or on the genitals.
Direct contact with sores or affected areas is the primary means of transmission.
There is no treatment possibility. But symptoms can be managed by some antiviral drugs.

Genital warts

Genital warts are a condition that can be brought on by some HPV strains with a lower risk.
People experience these skin-colored or white lumps on the genitalia or anus.
Although they are treated, the virus that causes them may still exist. (HPV can sometimes vanish on its own.)
Warts on the genitalia can also disappear on their own, although they can also reappear.
Applying a chemical cream or liquid, freezing them off, or burning them off are all possibilities if you want to get rid of them.

Pubic lice

Pubic lice (crabs) are tiny parasites that live on the body hair or skin, especially near the genitals, and spread through direct contact.
Symptoms include intense itching and different colored spots on the affected area.
Some medicated creams and shampoos can be used to kill the lice.

Trichomoniasis (Trich)

Trich is caused by the parasite Trichomonas vaginalis which damages the epithelium, which most frequently results in microulcerations in the vagina and urethra.
In most cases, it is asymptomatic. Symptoms may include itching, dysuria (painful urination), dyspareunia (Pain during intercourse), bad odor vaginal discharge, etc.
It is mostly transmitted through sexual contact or genital touching.
Even trich is not a bacterial infection, it can be treated with certain antibiotics like tinidazole, metronidazole, etc.

HIV/AIDS

Human immunodeficiency virus (HIV) causes acquired immunodeficiency syndrome (AIDS).
HIV can impair immunity, raise the chance of catching other viruses or germs, or even cause some types of cancer.
Many HIV-positive people live long, robust lives because of modern medical therapies.
However, if the virus is not treated, it can cause AIDS, which makes the body more susceptible to dangerous infections and diseases.
Rapid weight loss, excessive exhaustion, sores, infections, neurologic problems, and malignancy are all possible symptoms of AIDS.
HIV is spread via sexual contact, needle sharing, blood transfusion, mother to baby (during pregnancy, delivery, and breastfeeding), and contact with body fluids (sweat, saliva, tear).
There is neither known treatment options nor vaccination possibility for AIDS. However, highly active antiretroviral therapy (HAART) can slow the progression of the disease
Life expectancy without therapy is roughly three years because of the number of diseases that might be contracted as a result of a highly compromised immune system.

Risk Factors of Sexually Transmitted Diseases

Anyone who engages in sexual activity runs the risk of contracting an STD or STI. Several elements could raise that risk, such as:

Engaging in unprotected sex: The risk of contracting an STI is considerably increased by vaginal or anal penetration by an infected partner who is not wearing a latex condom.
Use of condoms improperly or inconsistently: The risk can also be increased by using condoms improperly or inconsistently. Even though oral sex is less dangerous, infections can still be spread without the use of a dental dam, which is a small, square piece of latex or silicone rubber.
Sexual contact with multiple sex partners: Your risk increases the more people you have sexual contact with.
Being forced to do sexual activity: Even though dealing with rape or assault can be challenging, it is crucial to visit a doctor as soon as possible to receive screening, treatment, and emotional support.
Improper alcohol consumption or drug use for fun: Misusing drugs or alcohol can impair your judgment, which makes you more likely to engage in unsafe activity.
Injecting drugs: Sharing needles can spread a variety of harmful viruses, such as hepatitis B, hepatitis C, and HIV.
Being a child of people aged 15 to 24 accounts for half of new STI cases.

Mode of Transmission of Sexually Transmitted Diseases

STDs can be transmitted through:

Direct contact with a lesion or sore.
Close intimate touch, in the case of pubic lice.
Coming into contact with infected blood.
Sharing of needles; coming into contact with vaginal fluid or semen.

Signs and Symptoms of Sexually Transmitted Diseases

The symptoms of STD can vary widely, including the absence of any. Because of this, they could not be discovered until difficulties arise or a partner is diagnosed. Following are some warning signs and symptoms of an STI:

Dysuria
Discharge from the penis
Unusual or odorous vaginal discharge
Unusual vaginal bleeding
Sore, swollen lymph nodes, often in the groin
Lower abdominal pain
Fever
Rash on the trunk, hands, or feet
Itching
Lesions (blisters, warts, or chancre sores)
Dyspareunia
Recurring infections.

Diagnosis of Sexually Transmitted Diseases

History collection: A thorough history of your most recent sexual encounters with anyone, including any associated symptoms.
Blood tests: for the presence of microorganisms.
Urine samples- for the presence of bacteria.
Microscopic examination: of the discharge from sores, ulcers, or vaginal and penile discharge for the presence of microbes.
Pap smear test: All women undergo the Pap test to check for abnormal cervical cell structure. These may manifest after exposure to specific HPV strains. Every three years, beginning at age 21, all women should have a pap smear.

Treatment/Management of Sexually Transmitted Diseases

The type of STI will determine the best method of treatment. Treatment options include symptom relief, symptom prevention, and infection cure. It is crucial to keep in mind that an STI can spread to a partner while receiving treatment. Typical therapies include:

Antibiotics: These are used to treat bacterial STIs like trichomoniasis, gonorrhea, chlamydia, and syphilis. Until the full course of antibiotics is finished, those who have these diseases should refrain from having intercourse.
Antiviral drugs: These prevent outbreaks of viral diseases, including herpes and HIV, and some of them can suppress HIV for a lifetime. Nevertheless, it is still possible to spread these STIs to a partner, so being cautious is essential.
Creams and lotions: These can be used to treat pubic lice and itching.

Complications of Sexually Transmitted Diseases

If an STDs patient does not receive appropriate therapy, they may get:

Pelvic inflammatory disease (PID)
Ectopic pregnancy
Infertility
Heart disease
Eye inflammation
Arthritis
Chronic pelvic pain
Urethritis and prostatitis in males
Some malignancies, such as rectal and cervical cancers linked to HPV.

Prevention of Sexually Transmitted Diseases

There are many strategies to prevent or lower your risk of contracting STDs or STIs.

Abstain: The best strategy to prevent STIs is to refrain from having sex.
Remain with one healthy partner: Being in a committed relationship for a long time when both partners only have sex with each other and neither is infected is another effective approach to preventing STIs.
Watch and check: Wait until you and your new partner have undergone STI testing before engaging in vaginal or anal sex. Although oral sex is less dangerous, avoid skin-to-skin contact between the oral and genital mucous membranes by using a latex condom or dental dam.
Vaccinate yourself: Certain STIs can be avoided by getting vaccinated early, before sexual contact. Viral infections like hepatitis A, hepatitis B, and the human papillomavirus (HPV) can be prevented with vaccines.
- The HPV vaccine can be given as early as age 9, although the Centers for Disease Control and Prevention (CDC) recommend it for girls and boys between the ages of 11 and 12. The CDC advises taking the vaccine up until age 26 if you weren’t fully immunized by the time, you were 11 or 12.
- Newborns often receive the hepatitis B vaccine, and children under the age of one are advised to receive the hepatitis A vaccine. Both vaccinations are advised for those who are not immune to these illnesses and for those who are more likely to contract them, such as men who engage in sexual activity with men and IV drug users.
Consistently and properly use dental dams and condoms: For every sexual act, whether oral, vaginal, or anal, use a fresh latex condom or dental dam. Never use a latex condom or dental dam with an oil-based lubricant, such as petroleum jelly.
Avoid abusing drugs or alcohol excessively: You’re more likely to take sexual risks if you are inebriated.
Communicate: Before engaging in any intense sexual activity, discuss safer sex techniques with your partner. Make sure you are clear about the actions that are not acceptable.
Consider having a man circumcised: There is evidence to suggest that circumcision can help men lower their risk of contracting HIV from a woman who has the disease by as much as 60%. Additionally, male circumcision may lessen the spread of genital HPV.
Take preexposure prophylaxis (PrEP) into consideration: The use of two medications in combination to lower the risk of HIV infection in patients who are at very high risk has been approved by the Food and Drug Administration (FDA). Emtricitabine plus tenofovir alafenamide fumarate (Descovy) and emtricitabine plus tenofovir disoproxil fumarate (Truvada) are the medications.

Prognosis

The prognosis depends on the patient’s overall health, comorbid conditions, the diagnosis of the specific disease, its degree and severity at the time of initial presentation, their desire to adhere to essential treatment, follow-up, and preventive measures, and their general health.
Success depends on the course of treatment and patient compliance if the disease process is identified in the acute phase and can be properly treated with antivirals, antibiotics, or antifungals.
When treating a chronic illness or a treatable infection like HIV, HSV-1/HSV-2, or partially treated or asymptomatic STDs, medication adherence is crucial.
The cultural stigmatization of STD patients and the lack of proper training for healthcare professionals leads to poor prognosis of diseases.
Workers in the sex trade, prostitutes, men who have sex with men, illegal drug users, convicts, and young people in nations with high incidences of STIs and HIV are among the populations most at risk.

Summary

STDs are a group of illnesses that can spread through sex between partners.
An STD could infect anyone who engages in sexual activity. But for those who engage in specific high-risk behaviors, such as having numerous sexual partners and not using a condom every time they have sex, the rate of STDs is significantly greater.
The first indicators of an STD frequently include sores on or around the genitals (vagina or penis), fluid flowing from the vagina or penis, and pain when peeing. Many STD patients, however, experience no symptoms.
Some STDs can cause lifelong complications if left untreated like AIDS, multiple organ damage, infertility, etc.
All STDs can be avoided. The majority, including gonorrhea and syphilis, are treatable with medicine.
Others, such as genital herpes and HIV/AIDS, cannot be cured but can still be treated and made better.

References

Garcia, M. R., Leslie, S. W., & Wray, A. A. (2022). Sexually Transmitted Infections. StatPearls Publishing. Retrieved on 2023, May 3 from https://pubmed.ncbi.nlm.nih.gov/32809643/
Fasciana, T., Capra, G., Lipari, D., Firenze, A., & Giammanco, A. (2022). Sexually Transmitted Diseases: Diagnosis and Control. International journal of environmental research and public health, 19(9), 5293. https://doi.org/10.3390/ijerph19095293
Fasciana, T., Capra, G., Di Carlo, P., Calà, C., Vella, M., Pistone, G., Colomba, C., & Giammanco, A. (2021). Socio-Demographic Characteristics and Sexual Behavioral Factors of Patients with Sexually Transmitted Infections Attending a Hospital in Southern Italy. International journal of environmental research and public health, 18(9), 4722. https://doi.org/10.3390/ijerph18094722
Caruso, G., Giammanco, A., Virruso, R., & Fasciana, T. (2021). Current and Future Trends in the Laboratory Diagnosis of Sexually Transmitted Infections. International journal of environmental research and public health, 18(3), 1038. https://doi.org/10.3390/ijerph18031038
Wagenlehner, F. M., Brockmeyer, N. H., Discher, T., Friese, K., & Wichelhaus, T. A. (2016). The Presentation, Diagnosis, and Treatment of Sexually Transmitted Infections. Deutsches Arzteblatt international, 113(1-02), 11–22. https://doi.org/10.3238/arztebl.2016.0011
Pfennig C. L. (2019). Sexually Transmitted Diseases in the Emergency Department. Emergency medicine clinics of North America, 37(2), 165–192. https://doi.org/10.1016/j.emc.2019.01.001
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021). Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 70(4), 1–187. https://doi.org/10.15585/mmwr.rr7004a1