Sexually transmitted diseases, or STDs, are grabbing increasing attention given that the category includes AIDS, often labelled as the plague of our century.
However, there are other important STDs that affect a large number of individuals and lead to disastrous consequences. These include Gonorrhea, Syphillis, Chlamydia, Herpes type II, Human Papilloma Virus (Warts), Hepatitis B, Trichimonis, Pubic Lice (CRABS). Different in origin, symptoms, treatment and outcomes, all these diseases share the way of transmission, where sexual intercourse is the primary vehicle.1. Prevalence of STDs.
The list of most important STDs has changed over time. Thus, syphilis was non-existent in pre-Columbian Europe. After Columbus’ trip to America, syphilis emerged as a devastating disease that used to plunder towns and villages, which gave scientists reasons to believe that it was brought over from the New World (Crosby, 1973, p. 124-126). In the 1960s the five most important STDs included gonorrhea, syphilis, granuloma inguinale, chancroid, and lymphogranuloma venereum (STDs: Yesterday and Today, 2004).According to the statistics publicised by the American Social Health Association, “more than half of all people will have an STD at some point in their lifetime” (ASHA, 2005). The same association estimates that one in two sexually active Americans gets infected with an STD by the age of 25, and one out of four teenagers per year will contract an STD. The compilation of reliable statistics is difficult since only a few sexually transmittd diseases including gonorrhea, syphilis, chlamydia, hepatitis A and B have to be reported to the health authorities when diagnosed.
However, these numbers show the prevalence of SDTs in contemporary society and demonstrate that this is a serious health issue that has to be addressed with adequate measures on prevention and cure.STDs are typically caused by bacteria, parasites, and viruses. Physicians use antibiotics to treat STDs cause by bacteria, but the problem is that the bacterium can develop a resistance to the medication, complicating treatment. Parasitic STDs are for the most part curable. The greatest challenge for humanity at this point is the viral STDs, including HIV/AIDS, as the virus tends to stay in the body for prolonged time periods without exhibiting any symptoms. Besides, “there are no known cures for viruses” (STDs: Yesterday and Today, 2004).
2. Primary STDs.HIV/ AIDS (Acquired immune deficiency syndrome) usually tops the list of concerns related to sexually transmitted diseases to the uniformly lethal outcome and unavailability of the cure. A person develops AIDS after contracting HIV (human immunodeficiency virus) that decreases the potential of the immune system to respond to infections and cancers. As a result, the host dies of a certain infection or cancer, although HIV can reside in the body for years without developing into AIDS.Gonorrhea is a curable bacterial infection and one of the oldest sexually transmitted diseases. The disease is found in both men and women, although in women it is more likely to reside without causing symptoms.
The bacterium affects many organs, including vagina, cervix, urethra, throat, and rectum.Syphilis, formerly known as the French disease, results from the contraction of “a bacterial spirochete that bores into the mucous membranes of the mouth or genitals” (STDs: Yesterday and Today, 2004). Syphilis develops in several stages, and it can take years before the disease reaches a stage in which it become incurable and leads to the death of the patient. In the initial stages it is treatable (NIAID, 2004).
Syphilis begins with the appearance of a chancre, an ulcer that can appear both inside and outside of the body and thus often passes unnoticed by the patient, in particular due to its painless character. The secondary stage is characterised by the appearance of a highly infectious rash on the body. After this the disease can transform into a latent process that will continue for years without causing any symptoms. Alternatively, syphilis can enter the tertiary stage which triggers “mental illness, blindness, other neurologic problems, heart disease, and death” (NIAID, 2004).Chlamydia is caused by bacterium that affects cervix, urethra, throat, and rectum. First reported in 1984, it “affects an estimated 3–5 million women annually” (STDs: Yesterday and Today, 2004). Chlamydia has a serious effect on fallopian tubes and can lead to infertility if not cured quickly. After treatment, Chlamydia can reside in the body for long periods of time.
Herpes virus (Type II) is transmitted through sexual intercourse when the virus gets into the mucous on the genitals. As with most viruses, this one is incurable and can remain in the body for a lifetime without demonstrating symptoms (STDs: Yesterday and Today, 2004). According to the American Social Health Association, 90% of those infected with herpes do not know about their infection (ASHA, 2005). Alternatively, it can break into a rash or ulcer on the skin. Herpes virus is believed to pose little danger to the body and mostly leads to discomfort; however, contracting genital herpes simplifies HIV infection, and so couples in which one partner has this disease usually choose to use condoms to protect the other partner from risk.Human Papillomavirus (HSV) is another viral infection that can reside with the host without triggering symptoms.
The most common symptom is warts, in particular genital warts. Recently, scientists established the connection between HSV and cervical and anal cancer, so contracting HSV raises the risk of cervical cancer in women. Among 80 and 100 strains of the virus, there are differing degrees of risk of causing cancer.Hepatitis B, like other varieties of hepatitis (Types A, C, D) leads to the inflammation of the liver, but differs from other types since it is contracted through sexual intercourse in 30% of the cases (STDs: Yesterday and Today, 2004). A person can recover from hepatitis without serious damage to health, although in many cases the disease can change into a chronic form or lead to a fatal outcome due to liver failure.3. STDs: Impact on Health.Many STDs, although not leading to fatal outcomes on their own, can lead to complications that will result in either death of the patient or permanent depression of a certain bodily function such as reproduction.
Thus, untreated gonorrhoea in women can result in a PID, pelvic infectious disease, especially if left untreated for many years. PID results in the formation of scars in the fallopian tubes that can block the passage of the fertilized egg into the uterus. The consequence can be a tubal (ectopic) pregnancy in which the embryo implants in the tube, occasionally causing a miscarriage or even resulting in a fatal outcome. In men, gonorrhoea results in epididymitis, affecting the testicles, and/or inflammation of the prostate gland.Similar effects appear in both men and women as a result of other STDs. PID is a common condition emerging in consequence of STD and can often lead to infertility.
Untreated, the infection leads to the blockage of the fallopian tubes precluding the fertilization of the egg. Half of PID cases are attributed to Chlamydia (NIAID, 2004). Often this process is not accompanied with any symptoms or inconvenience, and thus the condition progresses unnoticed.Any other STD increases the risk of contracting HIV.
For this reason, prevention and treatment of other STDs is important part of the efforts to reduce the spread of AIDS. Besides, measures that are part of the prevention campaigns against HIV, such as mutual monogamy (“having sex with only one, uninfected partner who only has sex with you”), condom use and regular check-ups are helpful against HIV as well as against other sexually transmitted diseases.4. Diagnosing and Prevention of STDs.Diagnosing and prevention of these dangerous diseases is an important issue in contemporary American society where high cost of medical services can isolate the uninsured portion of the population from regular check-ups necessary in order to prevent the development of the disease. The low level of concern among medical professionals is another problem.
A national survey of US doctors indicated that less than one-third of physicians regularly checked patients for STDs (St Lawrence J.S. et al., 2002, p.1784). Screening for Chlamydia, a disease that can cause lasting damage to a woman’s reproductive system leading to infertility, is at a disappointingly low level, since “in 2003 only 30% of women 25 and under with commercial health care plans and 45% in Medicaid plans were screened for Chlamydia” (ASHA, 2005).
Since early detection of the disease is often a decisive factor that determines the success of treatment, any program aiming to increase the effectiveness of an anti-STD campaign has to concentrate on stepping up measures for early diagnosis of sexually transmitted diseases. As stated before, regular check-ups can, for example, exclude deaths from syphilis that is treatable in early stages.Another part of efforts in combating STDs is to embark on an extensive prevention program.
A study conducted by Alexander McKay in Canada in 2000 focused on the research of effective interventions methods aimed at prevention of HIV and other STDs. His research indicates favourable outcomes of behavioral interventions with “adolescents, street youth, STI clinic patients, women, heterosexually active men, men who have sex with men, and communities” (McKay, 2000, p. 95).
The study aims at the development of a cost-effective method of STD prevention that will generate results in a cost-efficient manner. A successful prevention strategy, according to McKay has to take into consideration cultural factors and be conducted in a culturally appropriate fashion. Activists are encouraged to draw on the involvement of peer educators and community opinion leaders, putting sizeable effort into the promotion of condoms and safe sex. Campaigning has to evolve on both communal and individual planes, targeting broad masses of people as well as creating individual sexual health plans.
Another important area of fight against STDs is the research directed at the invention of new medications against these infections, as well as vaccines and diagnosis methods. Thus, a projected supported by the National Institute of Allergy and Infectious Diseases (NIAID) targets the development of new diagnosis methods that will allow doctors to pinpoint with greater precision the stage of the disease (NIAID, 2004). Molecular biologists are investigating various parts of the spirochete bacterium in order to prepare a vaccine that will provide for more efficient prevetion of this STD. Researchers are also trying to replace the current common diagnostic test for syphilis that requires a blood sample with one that will examine saliva or urine. The National Institute of Allergy and Infectious Diseases’ research on gonorrhoea focuses on several important issues, namely, “how this bacterium attaches to host cells”, “how it gets inside cells”, “gonococcal surface structures and how they can change”, and “human response to infection by gonococci” (NIAID, 2004). Dramatic improvements in treatment and diagnosis of STDs will be instrumental in stemming the spread of these diseases.ConclusionSTDs are a pervasive phenomenon in modern-day society that has come to the fore of public attention primarily due to HIV/AIDS.
Although AIDS is by far the deadliest STD at this point, the impact of other infections should not be overshadowed by the AIDS epidemic, since STDs affect a large proportion of population and carry permanent long-term risks due to their frequently latent character. These infections, caused by bacteria, viruses, and parasites, can lead to infertility, ectopic pregnancies and lethal outcomes. That is why efforts aimed at the prevention, diagnosis and treatment of STDs acquire increasing importance.