Viral STIs include genital warts, genital herpes, and HIV/AIDS.
Parasitic STIs include trichomoniasis.
Most STIs are treatable and curable, of the most common infections; syphilis, gonorrhea, chlamydia, and trichomoniasis are curable, while HIV/AIDS and genital herpes are not curable.
Some vaccinations may decrease the risk of certain infections including hepatitis B and few types of HPV.
Safe sex practices such as use of condoms, having smaller number of sexual partners, and being in a relationship in which each person only has sex with the other also decreases STIs risk.
Comprehensive sex education may also be useful.
STI diagnostic tests are usually easily available in the developed world, but they are often unavailable in the developing world.
There is often shame and stigma associated with STIs In 2015, STIs other than HIV resulted in 108,000 deaths worldwide.
Globally, in 2015, about 1.1 billion people had STIs other than HIV/AIDS.
About 500 million have either syphilis, gonorrhea, chlamydia or trichomoniasis. At least an additional 530 million have genital herpes, and 290 million women have human papillomavirus.
Historical documentation of STIs in antiquity dates back to at least the Ebers Papyrus (c. 1550 BCE) and the Hebrew Bible/Old Testament
Signs and symptoms
Not all STIs are symptomatic, and symptoms may not appear immediately after infection. In some instances a disease can be carried with no symptoms, which leaves a greater risk of passing the disease on to others. Depending on the disease, some untreated STIs can lead to infertility, chronic pain or death.
The presence of an STI in prepubescent children may indicate sexual abuse.
Symptoms and signs
symptoms worsen
. In recent years, the prevalence of syphilis has declined in Western Europe, but it has increased in Eastern Europe (former Soviet states). A high incidence of syphilis can be found in places such as Cameroon, Cambodia, Papua New Guinea.Syphilis infections are increasing in the United States.
Trichomoniasis is a common STI that is caused by infection with a protozoan parasite called Trichomonas vaginalis.
Trichomoniasis affects both women and men, but symptoms are more common in women.
Most patients are treated with an antibiotic called metronidazole, which is very effective.
HIV (human immunodeficiency virus) damages the body's immune system, which interferes with its ability to fight off disease-causing agents. The virus kills CD4 cells, which are white blood cells that help fight off various infections.
HIV is carried in body fluids and is spread by sexual activity. It can also be spread by contact with infected blood, breastfeeding, childbirth, and from mother to child during pregnancy.
When HIV is at its most advanced stage, an individual is said to have AIDS (acquired immunodeficiency syndrome).There are different stages of the progression of and HIV infection. The stages include primary infection, asymptomatic infection, symptomatic infection, and AIDS.
In the primary infection stage, an individual will have flu-like symptoms (headache, fatigue, fever, muscle aches) for about two weeks. In the asymptomatic stage, symptoms usually disappear, and the patient can remain asymptomatic for years. When HIV progresses to the symptomatic stage, the immune system is weakened and has a low cell count of CD4+ T cells. When the HIV infection becomes life-threatening, it is called AIDS. People with AIDS fall prey to opportunistic infections and die as a result.
When the disease was first discovered in the 1980s, those who had AIDS were not likely to live longer than a few years. There are now antiretroviral drugs (ARVs) available to treat HIV infections. There is no known cure for HIV or AIDS but the drugs help suppress the virus.
By suppressing the amount of virus in the body, people can lead longer and healthier lives. Even though their virus levels may be low they can still spread the virus to others.
Management
In the case of rape, the person can be treated prophylacticly with antibiotics
.
An option for treating partners of patients (index cases) diagnosed with chlamydia or gonorrhea is patient-delivered partner therapy, which is the clinical practice of treating the sex partners of index cases by providing prescriptions or medications to the patient to take to their partner without the health care provider first examining the partner.
In term of preventing reinfection in sexually transmitted infection, treatment with both patient and the sexual partner of patient resulted in more successful than treatment of the patient without the sexual partner. There is no difference in reinfection prevention whether the sexual partner treated with medication without medical examination or after notification by patient
The goal of sexually transmitted infection (sexually transmitted disease) treatment is to:
Cure many (not all) STIs.
Reduce your likelihood of spreading the infection.
Help you get healthy and stay healthy.
Prevention
Strategies for reducing STI risk include:
vaccination, mutual monogamy, reducing the number of sexual partners, and abstinence.
Also potentially helpful is behavioral counseling for sexually active adolescents and for adults who are at increased risk.
Such interactive counseling, which can be resource-intensive, is directed at a person's risk, the situations in which risk occurs, and the use of personalized goal-setting strategies.
The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids which can lead to transfer with an infected partner.
Not all sexual activities involve contact: cybersex, phone sex or masturbation from a distance are methods of avoiding contact. Proper use of condoms reduces contact and risk. Although a condom is effective in limiting exposure, some disease transmission may occur even with a condom
Both partners can get tested for STIs before initiating sexual contact, or before resuming contact if a partner engaged in contact with someone else.
Many infections are not detectable immediately after exposure, so enough time must be allowed between possible exposures and testing for the tests to be accurate. Certain STIs, particularly certain persistent viruses like HPV, may be impossible to detect.
Some treatment facilities use in-home test kits and have the person return the test for follow-up. Other facilities strongly encourage that those previously infected return to ensure that the infection has been eliminated. Novel strategies to foster re-testing have been the use of text messaging and email as reminders. These types of reminders are now used in addition to phone calls and letters.
After obtaining a sexual history, a healthcare provider can encourage risk reduction by providing prevention counseling. Prevention counseling is most effective if provided in a nonjudgmental and empathetic manner appropriate to the person's culture, language, gender, sexual orientation, age, and developmental level. Prevention counseling for STIs is usually offered to all sexually active adolescents and to all adults who have received a diagnosis, have had an STI in the past year, or have multiple sex partners
Vaccines
Vaccines are available that protect against some viral STIs, such as hepatitis A, hepatitis B, and some types of HPV.
Vaccination before initiation of sexual contact is advised to assure maximal protection. The development of vaccines to protect against gonorrhea is ongoing.
Condoms
Condoms and female condoms only provide protection when used properly as a barrier, and only to and from the area that they cover. Uncovered areas are still susceptible to many STIs.
In the case of HIV, sexual transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin; therefore, properly shielding the penis with a properly worn condom from the vagina or anus effectively stops HIV transmission. An infected fluid to broken skin borne direct transmission of HIV would not be considered "sexually transmitted", but can still theoretically occur during sexual contact.
This can be avoided simply by not engaging in sexual contact when presenting open, bleeding wounds.
Other STIs, even viral infections, can be prevented with the use of latex, polyurethane or polyisoprene condoms as a barrier.
Some microorganisms and viruses are small enough to pass through the pores in natural skin condoms but are still too large to pass through latex or synthetic condoms.
Proper male condom usage entails:
Not putting the condom on too tight at the tip by leaving 1.5 centimetres (0.6 in) room for ejaculation. Putting the condom on too tightly can and often does lead to failure.
Wearing a condom too loose can defeat the barrier
Avoiding inverting or spilling a condom once worn, whether it has ejaculate in it or not
If a user attempts to unroll the condom, but realizes they have it on the wrong side, then this condom may not be effective
Being careful with the condom if handling it with long nails
Avoiding the use of oil-based lubricants (or anything with oil in it) with latex condoms, as oil can eat holes into them
Using flavored condoms for oral sex only, as the sugar in the flavoring can lead to yeast infections if used to penetrate
In order to best protect oneself and the partner from STIs, the old condom and its contents are to be treated as infectious and properly disposed of.
A new condom is used for each act of intercourse, as multiple usages increase the chance of breakage, defeating the effectiveness as a barrier.
In the case of female condoms, the device consists of two rings, one in each terminal portion. The larger ring should fit snugly over the cervix and the smaller ring remains outside the vagina, covering the vulva. This system provides some protection of the external genitalia.
History
The first well-recorded European outbreak of what is now known as syphilis occurred in 1494 when it broke out among French troops besieging Naples in the Italian War of 1494–98.
The disease may have originated from the Columbian Exchange.
From Naples, the disease swept across Europe, killing more than five million people.As Jared Diamond describes it,
syphilis was first definitely recorded in Europe in 1495, its pustules often covered the body from the head to the knees, caused flesh to fall from people's faces, and led to death within a few months," rendering it far more fatal than it is today. Diamond concludes, "[B]y 1546, the disease had evolved into the disease with the symptoms so well known to us today.
Gonorrhea is recorded at least up to 700 years ago and associated with a district in Paris formerly known as "Le Clapiers"
. This is where the prostitutes were to be found at that time.
Prior to the invention of modern medicines, sexually transmitted infections were generally incurable, and treatment was limited to treating the symptoms of the infection. The first voluntary hospital for STIs was founded in 1746 at London Lock Hospital.
Treatment was not always voluntary: in the second half of the 19th century, the Contagious Diseases Acts were used to arrest suspected prostitutes. In 1924, a number of states concluded the Brussels Agreement, whereby states agreed to provide free or low-cost medical treatment at ports for merchant seamen with STIs. A proponent of these approaches was Nora Wattie, OBE, Venereal Diseases Officer in Glasgow from 1929, encouraged contact tracing and volunteering for treatment, rather than the prevailing more judgemental view and published her own research on improving sex education and maternity care.
The first effective treatment for a sexually transmitted infection was salvarsan, a treatment for syphilis. With the discovery of antibiotics, a large number of sexually transmitted infections became easily curable, and this, combined with effective public health campaigns against STIs, led to a public perception during the 1960s and 1970s that they have ceased to be a serious medical threat.
During this period, the importance of contact tracing in treating STIs was recognized.
By tracing the sexual partners of infected individuals, testing them for infection, treating the infected and tracing their contacts, in turn, STI clinics could effectively suppress infections in the general population.
In the 1980s, first genital herpes and then AIDS emerged into the public consciousness as sexually transmitted infections that could not be cured by modern medicine.
AIDS, in particular, has a long asymptomatic period—during which time HIV (the human immunodeficiency virus, which causes AIDS) can replicate and the disease can be transmitted to others—followed by a symptomatic period, which leads rapidly to death unless treated.
HIV/AIDS entered the United States from Haiti in about 1969.
Recognition that AIDS threatened a global pandemic led to public information campaigns and the development of treatments that allow AIDS to be managed by suppressing the replication of HIV for as long as possible.
Contact tracing continues to be an important measure, even when diseases are incurable, as it helps to contain infection.
World War II–era British poster urging men to be tested for sexually transmitted infections before marriage
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