Sexually Transmitted Infections

 

  

What are sexually transmitted infections.

Sexually transmitted infections or sexually transmitted diseases are diseases that are passed on from one person to another through sexual contact, via oral sex, anal sex and virginal intercourse.

More than 30 different viruses, bacteria, and parasites are identified to be transmitted through sexual contact. Syphilis, Gonorrhea, Chlamydia and Trichomoniasis are curable. Hepatitis B, herpes, HIV, and human papillomavirus (HPV) caused by virus are currently currently incurable. Symptoms or disease due to the incurable viral infections can be reduced or modified through treatment.

How are they transmitted?

• Sexually transmitted infections are spread predominantly by sexual contact, including vaginal, anal and oral sex. 
• Sexually transmitted infections can also be spread through non-sexual means such as via blood or blood products.  
• Sexually transmitted infections including Chlamydia, gonorrhea, primarily hepatitis B, HIV, and syphilis can also be transmitted from mother to child during pregnancy and childbirth. 
• A person can have sexually transmitted infections without having obvious symptoms of the disease. Common symptoms of sexually transmitted infections include vaginal discharge, urethral discharge, burning in men, genital ulcers, and abdominal pain.

Sexual transmitted infections Facts

•         Over 1 million sexually transmitted infections are acquired every day worldwide.
•          Over 357 million new infections each year.
•          More than 500 million people are estimated to have genital infection with herpes.
•          More than 290 million women have a human papillomavirus (HPV).
•          The majority of Sexually transmitted infections have no symptoms or only mild symptoms that may not be recognized as an Sexual transmitted infections.
•          Sexual transmitted infections such as HSV type 2 and syphilis can increase the risk of HIV acquisition.
•         Over 900 000 pregnant women were infected with syphilis resulting in approximately 350 000 adverse birth outcomes including stillbirth in 20122.
•        HPV infection causes 528 000 cases of cervical cancer and 266 000 cervical cancer deaths each year.
•        Sexual transmitted infections such as gonorrhea and chlamydia are major causes of pelvic inflammatory disease and infertility in women. In some cases, Sexually transmitted infections can have serious reproductive health consequences beyond the immediate impact of the infection itself (e.g., infertility or mother-to-child transmission.
•       Drug resistance, especially for gonorrhea, is a major threat to reducing the impact of Sexually transmitted infections worldwide.

                     Data Source: W.H.O.

     Who is at risk of sexually transmitted infections?

• Sexually active men or women. 
•  A sexually active girl or woman under age 25.
• Woman older than 25 and at risk of STIs. 
• Man who has sex with men.
• Having sex with multiple partners.
• Use of intravenous drugs (IV).

 Approaches to preventing of sexually transmitted infections

Sexual transmitted disease can be prevented through various ways which includes: Barrier methods, Counseling and behavioral approaches. This approaches offers primary prevention against Sexually transmitted infections, when used consistently and correctly. These include:

• Vaccination (Hepatitis B and HPV)  
• Condom use and promotion
• Sex education on Sexually transmitted infections
• HIV pre-test and post-test counseling
• Safe sex counseling
• Risk-reduction counseling.

  Treatment for Sexually transmitted infections

         Chlamydia, gonorrhea, syphilis and trichomoniasis are curable using effective antibiotics.

         HIV and Herpes, antiviral are mist effective for them, however they cannot cure the disease.

         Hepatitis B, immune system modulators (interferon) and antiviral medications can fight the virus and slow    liver damage.

  Sexually transmitted infections testing and diagnosis

• Chlamydia and gonorrhea

1. Using swab: cotton bud is gently wiped over the area that might be infected, inside the penis in men and cervix in women respectively. 
2. Urine test: this should ideally be done after at least one or two hours since you last urinated.
3. Nucleic acid amplification test (NAAT). This test finds the genetic material (DNA) of Chlamydia bacteria.  It’s a very reliable test for Chlamydia. 
4. Chlamydia culture: In a laboratory

• Syphilis

1. Venereal disease research laboratory (VDRL) test: The VDRL test checks blood or spinal fluid for an antibody that can be produced in people who have syphilis.  
2. Rapid plasma reagin (RPR) test: The RPR test also finds syphilis antibodies. 
3. Enzyme immunoassay (EIA) test: This blood test checks for syphilis antibodies. A positive EIA test should be confirmed with either the VDRL or RPR tests. 
4. Fluorescent treponemal antibody absorption test: The (FTA-ABS) test also checks for antibodies. It can be used to find syphilis except during the first 3 to 4 weeks after exposure.
5. Darkfield microscopy: This test uses a special microscope to look for the syphilis germ, the test is used mainly to diagnose syphilis in an early stage. 
6. Microhemagglutination assay (MHA -TP): This test is a confirmatory test for syphilis.

• HIV

1. ELISA Test: This stands for enzyme-linked immunosorbent assay, is used to detect HIV infection.
2.  Viral Load Test: This test measures the amount of HIV in your blood.
3. Western Blot:  This is a confirmatory test to confirm a positive ELISA test result.

• Hepatitis

1. Hepatitis B surface antigen test (HBsAg).
2. Anti-hepatitis B surface antibody test.
3. Hepatitis B core antigen test (HBcAb)

• Genital Herpes

1. Viral culture: This test involves taking a tissue sample or scraping of the sores for examination in the laboratory. 
2. Blood test: This test analyzes a sample of your blood for the presence of HSV antibodies to detect a past herpes infection.
3. PCR blood test: The PCR test looks for pieces of the virus's DNA. This is the most common test used to diagnose genital herpes.

• HPV

1. Vinegar used in genital examination - vinegar can make warts more visible. 
2. Pap smear: Check cervix for abnormal cells recommended for women between ages 21 and 65.

   Management of Sexual transmitted infections.

1.   Early recognizable signs and symptoms and initiate same-day treatment, and avoids expensive or unavailable treatment.
2. Vaccines administration for hepatitis B and HPV, for prevention.
3. Male circumcision reduces the risk of acquiring HIV infection by over 60%, also reduce the likelihood of other Sexually transmitted infections.