Sexually transmitted diseases (STDs) or sexually transmitted infections (STIs) are infections that are transmitted through sexual contact. It is commonly spread through vaginal, oral, or anal sex, but they can also be transmitted through other types of contact such as skin-to-skin contact, sharing sex toys, during pregnancy, childbirth, or breastfeeding. The World Health Organisation reveals that more than 1 million sexually transmitted infections (STIs) are contracted every day globally. 

 

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The frequency of sexually transmitted infections can vary significantly across different populations and geographic regions. In India, the prevalence of these STIs among the general population is relatively low.

 

A 2022 report issued in PLoS One shows that the prevalence of four curable sexually transmitted infections among the general population in India is around 4 per cent. Surprisingly, higher rates of STDs are observed among subpopulations with high-risk behaviours, such as men who have sex with men (MSM), transgender (TG), injecting drug users (IDUs), and female sex workers (FSWs). These populations are considered key populations for STI prevention and control efforts because of their elevated risk for infection and the potential for transmission to the wider community.

 

Sexual contact can transmit a variety of bacteria, viruses, and parasites. Some examples include:

• Bacteria: Chlamydia, gonorrhoea, syphilis, and bacterial vaginosis
• Viruses: HIV, HPV (human papillomavirus), herpes simplex virus (HSV), hepatitis B and C, and cytomegalovirus (CMV)
• Parasites: Trichomoniasis, pubic lice (crabs), and scabies

 

Symptoms of Sexually Transmitted Infections

Sexual health problems can have a significant impact on a person's quality of life, and it is important to address them promptly to prevent further complications. The symptoms of sexually transmitted infections (STIs) can vary depending on the type of infection. Some common symptoms of STDs include:

 

1. Painful urination or discharge from the genitals: If you notice a discharge from the vagina or penis, or a strong odour, can be a sign of an STI like bacterial vaginosis or trichomoniasis.
2. Sores or bumps on the genitals or anus: Some STIs, such as herpes and syphilis, can cause sores, blisters, or bumps on or around the genitals or anus. These can be painful or itchy and may ooze or bleed.
3. Pain during defecation: Pain or bleeding around the anus during defecation is one of the signs of STIs like gonorrhoea, chlamydia, or herpes.
4. Pain during sex: Pain during sex can be a sign of an STI, especially if it is accompanied by other symptoms like discharge or sores around penis or vagina.
5. Itching or irritation in the genital area: This can be a sign of an STI like pubic lice or scabies.

 

It's important to remember that not all STIs cause symptoms, so it's possible to have an infection and not know it. Regular testing is important to detect and treat STIs early, even if you don't have any symptoms.

 

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Types of Sexually Transmitted Diseases

1. Gonorrhoea: Gonorrhoea can cause rectal pain, bleeding, and discharge.
2. Chlamydia:  Chlamydia can cause rectal pain, bleeding, and discharge.
3. HIV/AIDS: HIV can weaken the immune system and make it easier for other STIs to cause rectal symptoms.
4. Human Papillomavirus Virus (genital warts): HPV can cause perianal warts. 
5. Hepatitis A & B: It spreads  by exposure to infected bodily fluids, like sexual activities. has vaccine
6. Herpes: Herpes can cause painful sores on or around the anus.
7. Syphilis: Syphilis can cause rectal pain, bleeding, and ulcers.

 

Who is at risk?

Sexually transmitted infections (STIs) are a common public health problem globally. According to the World Health Organization, there are an estimated 376 million new cases of four curable STIs - chlamydia, gonorrhoea, syphilis, and trichomoniasis - that occur annually worldwide among people aged 15-49 years.

 

• Teens and adolescents: As per a 2018 study issued by the paper Current Opinion in Pediatrics, Young people are more likely to get involved in risky sexual activities and are more likely to have multiple partners. This increases the chances of them getting infected more than other age groups.
• LGBTQ community: Gay and bisexual men, or other men who have sex with men (MSM), are immensely affected by syphilis, HIV, and other STIs. According to a 2011 study published in the American Journal of Public Health, unprotected anal intercourse (for both men and women) increases the likelihood of contracting an STI because of the rigidity and fragility of rectal tissue. This makes anal tissue more susceptible to tearing and at a higher risk of becoming infected. 
• People with multiple partners: The more partners you have, the higher the chances of being exposed to an STI. An individual may have multiple sexual partners, who are also with other sexual partners, increases the risk of transmission for STDs.
• Those with substance/alcohol abuse: Alcohol and drugs can impair judgement and decision-making abilities, making it more difficult to make safe and responsible choices about sexual activity. This can include engaging in unprotected sex or having sex with partners who may have an STI without taking appropriate precautions, such as using barrier methods like condoms or dental dams for anal or oral sex.
• Pregnant or lactating mothers: People who are pregnant can transmit certain sexually transmitted infections (STIs) to their foetuses through vertical transmission or breast milk. Vertical transmission refers to the transmission of an infection from a pregnant person to their foetus during pregnancy, labour, or delivery. Some STIs that can be transmitted through vertical transmission and breastfeeding include HIV, syphilis, and hepatitis B.
• Getting unregulated tattoos and cosmetic procedures: A 2022 systematic review by PLos One shows that transfusion-transmitted diseases can be transmitted through blood transfusions or blood products from needles during getting a tattoo or cosmetic surgeries. Common blood-transfusion infections are hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV), as well as bacterial infections like syphilis.

 

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Diagnosis

To diagnose the presence of the infection or abnormalities, a healthcare provider may look for visible signs of an STD, such as sores, warts, or rashes. They may also perform a pelvic exam, genital exam, vaginal swab, or rectal exam.

 

Furthermore, blood tests may be conducted by the health examiner to detect syphilis, HIV, Hepatitis B, and genital herpes. 

 

For STDs that cannot be diagnosed through a physical exam, laboratory tests are usually required. For example, a swab of fluid or cells from the vagina, penis, or anus may be taken and examined under a microscope to detect the presence of certain STDs, such as chlamydia or gonorrhoea and trichomoniasis.

 

Related Story: Living A Full Life And Successfully Managing HIV

 

Treatment

The four curable STIs syphilis, gonorrhoea, chlamydia, and trichomoniasis, are all caused by bacteria or parasites and can be effectively treated with antibiotics if detected and diagnosed early. Your doctor can prescribe medicine to treat chlamydia and gonorrhoea. Other STDs, like herpes, can’t be cured, but you can take medicine to minimise the symptoms.

 

According to the World Health Organisation, treatments for specific STDs is available today, including:

• Three bacterial (chlamydia, gonorrhoea and syphilis) and one parasitic STIs (trichomoniasis) are generally curable with existing single-dose regimens of antibiotics.
• For herpes and HIV, the most effective medications available are antivirals that can modulate the course of the disease, though they cannot cure the disease.
• For hepatitis B, antivirals can help fight the virus and slow damage to the liver.

 

It's important to see a healthcare provider if you experience any of these symptoms, as they can be indicative of a more serious underlying condition. 
 

Prevention

Effective prevention and control of STIs require a comprehensive approach that includes measures such as increased access to testing and treatment, condom promotion and distribution, targeted education and outreach, and stigma reduction efforts.

• It's important to practise safe sex to reduce the risk of contracting or spreading these infections. 
• Prevention involves using barrier methods such as condoms or dental dams, getting vaccinated for HPV and hepatitis B, and getting tested regularly for STIs. 
• If you are ever treated for an STD, be sure to complete the course of your medicine. It will be better if you avoid having sex until you and your partner, both have been treated.
• Addressing the social and structural factors that contribute to STI risk among key populations, such as poverty, discrimination, and lack of access to healthcare, is also critical for achieving reductions in STI incidence and prevalence.

 

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What STDs Can Be Prevented Through Vaccination?

Vaccines are an important tool in fighting the spread of infectious diseases, including those that can be transmitted through sexual activity. There are vaccines available for several sexually transmitted infections (STIs), including HPV, Hepatitis A, and Hepatitis B. It is important to note that vaccines are not a substitute for safe sex practices, such as using condoms and getting regular STI testing. However, they can play an important role in protecting against certain STIs and preventing the spread of these infections.

1. Human Papillomavirus Vaccine: Human Papillomavirus or HPV, is the most common type of sexually transmitted infection. The deceptive part of it is asymptomatic and some of the strains could potentially cause cervical cancer in women or oropharyngeal cancer in both sexes. The good news is that a vaccine is available to prevent the surge of infection. 
2. Hepatitis A Vaccine: Hepatitis A is a type of liver disease that is contracted due to dirty food or water. Besides, one can also contract it from certain sexual activities. There is good news, though: hepatitis A is totally preventable when you get the vaccine, which consists of two shots administered six months apart.
3. Hepatitis B Vaccine: Hepatitis B is also a liver disease, but it is mainly contracted through the exchange of infected bodily fluids and getting tattoos with infected needles. You can receive this vaccine in a series of two, three, or four injections.

 

Can STDs Impact Fertility?

Chlamydia and gonorrhoea are sexually transmitted diseases (STDs) that can cause infertility. Chlamydia and gonorrhoea are treatable infections with antibiotics. If left untreated, chlamydia and gonorrhoea can spread to the uterus or fallopian tubes causing pelvic inflammatory disease (PID). It can result in inflammation, scarring, and blockage in the fallopian tubes that prevents the eggs from travelling to the uterus. Individuals who have damage to their fallopian tubes are also at risk for ectopic pregnancy.

 

Related story: How To Practice Safe Sex

 

How to Mitigate STD Risk

According to the Centers For Diseases And Control Preventions, the most reliable means to avoid contracting sexual infections is to avoid having risky sex. Besides, there are several ways or lifestyle modifications that one can incorporate to prevent themselves from getting infected in the first place.

• Use a contraceptive or condom
• Reduce the number of sex partners
• Avoid using unregulated needles/syringes
• Vaccinations
• Get yourself tested for sexually transmitted infections annually

 

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