Sexually transmitted disease, also called STD, is any disease spread primarily through intimate sexual activity. Many bacteria, viruses, and other kinds of germs cause STD’s. Experts also refer to these diseases as sexually transmitted infections (STI’s), especially before symptoms develop. Sexually transmitted diseases were once commonly called venereal << vuh NIHR ee uhl >> diseases.
STD’s are a major health problem throughout the world. The most commonly transmitted bacterial STD in the United States, chlamydia << kluh MIHD ee uh >>, infects more than 1 million Americans each year. Chlamydia can cause a pelvic inflammatory disease in women who are infected, which can lead to infertility. HIV is another sexually transmitted infection. HIV is the virus that causes AIDS, a deadly disease. Other widespread STD’s include gonorrhea, genital herpes, and syphilis.
How STD’s are transmitted.
STD’s are transmitted almost entirely through sexual intercourse with an infected person. Most germs that cause STD’s die quickly outside the human body. For this reason, STD’s are not transmitted through contaminated objects, such as eating utensils, towels, and toilet seats; or through casual contact, such as coughing, sneezing, or swimming in the same swimming pool.
Most of the common STD’s can be transmitted from an infected pregnant woman to her baby. Transmission may occur as the fetus develops within the uterus or during childbirth and can cause complications for both the woman and the baby.
Factors in the spread of STD’s.
An individual’s chances of becoming infected with an STD depend on a variety of factors. STD’s can affect people from all social and economic backgrounds. People with the greatest amount of risk are those who begin sexual activity at an early age, have many sex partners, or engage in sexual intercourse with high-risk individuals, such as prostitutes.
Cultural attitudes and values often affect the sexual behavior of individuals and thus influence their chance of STD infection. In the United States, changes in social and sexual customs have contributed to an increased risk of STD’s. These changes are (1) a dramatic increase in premarital sexual intercourse, (2) a decrease in the average age at which people first have intercourse, and (3) increased acceptance of having more than one sex partner. All these changes have contributed to an increase in the number of sexually active people in danger of becoming infected with an STD. In the 1980’s and 1990’s, however, sexual behavior in many groups became more cautious because of the AIDS epidemic.
Within any society, there are individuals whose sexual behavior makes them highly likely to be infected with an STD and to transmit it to others. STD-infected people also tend to delay seeking treatment for their illness. They do not consult a doctor immediately because they either do not have or do not recognize the symptoms. Some do not see a doctor because they do not have access to good medical care. Poverty and a lack of educational and economic opportunities are associated with high rates of sexually transmitted diseases.
Biological factors also can affect a person’s risk of STD infection. Individuals with genital ulcers may be more vulnerable than others to infection with HIV, the virus that causes AIDS. In addition, some STD-causing organisms become resistant to the drugs used for treatment, complicating efforts to control the spread of the STD. For example, some forms of the bacterium that causes gonorrhea have become resistant to penicillin and other antibiotics that are commonly used to treat this infection.
Diagnosis and treatment.
For a person who shows few or no symptoms, doctors will often perform an STD test if the person reported a risky behavior or a sexual encounter. If a person shows obvious symptoms, doctors may order a variety of laboratory tests to confirm the presence of the infecting organisms. The most important factor after the diagnosis of an STD is obtaining appropriate medical care.
Doctors prescribe antibiotics to treat a variety of STD’s. Such STD’s, which include chlamydia, gonorrhea, and syphilis, can be cured easily if the drugs are prescribed early in the course of the illness. However, failure to receive prompt medical treatment can lead to serious, even life-threatening, complications. For example, syphilis that remains untreated can lead to heart or brain damage.
Viral STD’s, including herpes and HIV, are incurable. Patients may carry these infections for many years without developing symptoms. In addition, in herpes and certain other viral STD’s, patients may experience symptoms that go away, only to recur months or years later. Doctors can prescribe drugs to prevent or delay the development or recurrence of symptoms, and to reduce the severity of symptoms when they appear.
Prevention and control.
The most effective strategies for staying free of STD’s are to abstain from sexual intercourse altogether or to limit such contact to one uninfected partner who, in turn, has no other sexual partners. People can significantly reduce the chance of infection by using condoms or other protective measures during sex, by avoiding sex with prostitutes and other high-risk individuals, and by not using illegal drugs.
Controlling the spread of chlamydia, syphilis, and other bacterial STD’s requires early treatment of infected individuals and their sexual partners. Screening people for STD’s, even when they do not show any symptoms, is very effective. Many hospitals and community health centers have special clinics for the treatment of sexually transmitted diseases. Treatment is usually accompanied by education to encourage changes in the patient’s sexual behavior. Educational campaigns in schools and the community may help limit the spread of bacterial STD’s. Controlling the spread of HIV and other viral STD’s is more difficult because the diseases are incurable. People with sexually transmitted diseases—particularly viral STD’s—often are unaware of their infection and may infect many others. Education is thus the best tool for controlling the spread of viral STD’s.
Individuals who believe they may have a sexually transmitted disease should see a physician immediately. They should also stop all sexual activity until told by a physician that they are not at risk of infecting others.
