Today, professionals use the terms STD (sexually transmitted disease) or STI (sexually transmitted infection) to discuss infections that are transmitted from one infected person to another through vaginal sex, anal sex, oral sex or through close intimate sexual contact. The term “STI” is used more often because people can have an infection without it actually turning into a disease.
DIAGNOSIS OF STIs
Etiologic diagnosis based on laboratory testing: Preferred and most accurate method to identify specific pathogens so that appropriate treatment can be given.
Presumptive etiologic diagnosis based on clinical findings: Depends on specificity and positive predictive value of signs and symptoms for particular infections and expertise of a clinician.
Syndromic diagnosis: Aims to provide treatment for the majority of curable etiologies of a particular syndrome.
Bacterial Vaginosis: BV is the most common vaginal infection in women of reproductive age and it occurs when there is an overgrowth of certain “bad” bacteria in the vagina. Patients complain of non itchy, excessive, fowl-smelling vaginal secretions.
Candidiasis: It affects females more than males. Candidiasis presents as severely itchy, curdy white discharge. Patients can suffer from severe redness and erosions due to continous itching in the groins. It spreads between partners so both of them should be treated together to prevent further attacks.
Herpes: Herpes is a common viral STD. Initially bacterial STIs were more common; but with the rise of HIV era viral STIs are increasingly seen. It appears as water filled boils which can be painful and itchy. If not treated on time it can be secondarily infected with bacterial infection.
Human Papillomavirus (HPV) & Genital Warts: Warts are very commonly seen and at least 50% of sexually active people will get it at some time in their lives. It is caused by Human Papillomavirus and seen as outgrowths along the genital region. The body usually clears HPV on its own without causing any problems, but HPV can lead to certain kinds of cancer like cervical cancer in females.
Chlamydia: Chlamydia is one of the most common STDs and is the leading cause of preventable infertility. If left untreated, Chlamydia may also lead to pelvic inflammatory disease and the risk of ectopic pregnancy in women. Chlamydia is both treatable and preventable.
Molluscum Contagiosum: Molluscum contagiosum is caused by a virus that can be spread sexually and by non-sexual contact through contaminated objects like towels, clothing or sex toys. They are seen as asymptomatic, pearly white boils on the genitals and extra-genital areas.
Gonorrhea: Gonorrhea is one of the common STDs and can lead to infertility in men and women. It is both treatable and preventable, though scientists have discovered a new strain of gonorrhea that is resistant to all currently utilized antibiotics.
Trichomoniasis: Trichomoniasis is a curable STI.
LESS COMMON STDs:
Chancroid: Chancroid is a bacterial STI that is only spread through sexual contact. It causes painful ulcers or sores in the genital region.
Hepatitis: There are three different kinds of hepatitis, some of which are spread more easily than others. Hepatitis A, B and C can all be transmitted sexually, however hepatitis B is the type most likely to be sexually transmitted. All types of hepatitis are serious and affect the liver. Hepatitis B and C are the leading cause of liver cancer and are the most common reason for liver transplants.
HIV/Aids: The Human Immunodeficiency Virus (HIV), the virus that causes Acquired Immune Deficiency Syndrome (AIDS), is transmitted by blood and body fluids.
Lymphogranuloma Venereum: LGV is not very common and is most often seen in individuals who have had unprotected receptive anal sex. They present as spreading ulcers along the extra-genital region.
Mucopurulent Cervicitis (MPC): MPC is caused by Chlamydia, gonorrhea or other STIs, and can lead to PID if left untreated.
Pelvic Inflammatory disease (PID): PID can be caused by many different bacteria, including Chlamydia and gonorrhea. It occurs when these bacteria move up from the vagina or cervix into the uterus and other reproductive organs.
Pubic Crab Lice: Pubic or “crab” lice are parasitic insects that survive by feeding on human blood. Pubic lice are different parasites than head or body lice and are usually found in the pubic hair, but can also be found in other course body hair like eyebrows, beard, chest or armpit hair.
Scabies: Scabies are parasites that infect the skin and cause really intense itching. Scabies are transferred by skin-to-skin contact and can occur anywhere on the body.
This means that while scabies can be passed through sexual contact, it is usually passed through non-sexual skin-to-skin contact.
Syphilis: Syphilis is spread by contact with open sores (usually during sex). If left untreated it can cause serious health problems, including brain and nervous system
damage, blood infection and even death. If early action is taken, syphilis can be cured with antibiotics. Syphilis prevalence is growing, particularly among men who have sex with men.
Get the facts: Arm yourself with basic information about STDs.
Take control: Once you have the facts; protect yourself and your sexual partners. Effective strategies for reducing STD risk include:
Abstinence: The most reliable way to avoid infection is to not have sex. (i.e., anal, vaginal or oral).
Vaccination: Vaccines are safe, effective and recommended ways to prevent hepatitis B and HPV. HPV vaccines for males and females can protect against some of the most common types of HPV. It is best to get all three doses (shots) before becoming sexually active.
Mutual monogamy: Mutual monogamy means that you agree to be sexually active with only one person who has agreed to be sexually active only with you. Being in a long-term mutually monogamous relationship with an uninfected partner is one of the most reliable ways to avoid STDs. But you must both be certain you are not infected with STDs. It is important to have an open and honest conversation with your partner.
Reduced number of sex partners: Reducing your number of sex partners can decrease your risk for STDs. It is still important that you and your partner get tested and that you share your test results with one another.
Condoms: Correct and consistent use of the male latex condom is highly effective in reducing STD transmission. Use a condom every time you have anal, vaginal or oral sex.
Put yourself to the test: Knowing your STD status is a critical step to stopping STD transmission. If you know you are infected you can take steps to protect yourself and your partners.
Many STDs can be easily diagnosed and treated. If either you or your partner is infected, both of you need to receive treatment at the same time to avoid getting re-infected.
Dr. Shefali Trasi
Dr. Shefali Trasi is a M.B.B.S., MD ( dermatology, leprology and venerology). She has 3 years of PG training in dermatology, venerology and leprology. She practices at Dr. Trasi’s Clinic. She is also attached to Ramakrishna mission hospital, Khar and B.C.J General hospital, Santacruz West. She is a member of the European Academy Of Dermatology and American Academy Of Dermatology.