Today is our topic of discussion Sexually Transmitted Diseases
Sexually Transmitted Diseases
Definition of STD (or venereal disease):
These are the infections that are commonly transmitted through unprotected sexual contact with an infected partner.
RTI (Reproductive Tract Infection) include all reproductive tract infections irrespective of sexual transmission, e.g., vaginal discharge due to Bacterial Vaginosis or Vaginal Candidiasis.
Classification of Sexually Transmitted Diseases:
According to causative agent:
Bacterial STD:
1. Gonorrhoea (Neisseria gonorrhoeae)
2. Syphilis (Treponema pallidum)
3. Non-gonococcal urethritis (Chlamydia trachomatis & Ureaplasma urealyticum)
4. Lymphogranuloma venereum (Chlamydia trachomatis)
5. Chancroid (Haemophilus ducreyi) aubong boold be boold
6. Granuloma inguinale (Calymmatobacterium granulomatis) ange-alboon to grade
7. Bacterial vaginitis (Gardnerella vaginalis)
Viral STD:
1. AIDS (Human immunodeficiency virus)
2. Anogenital herpes simplex (Herpes simples virus)
3. Viral hepatitis (Hepatitis B & C virus)
4. Genital warts (Human papilloma virus)
5. Molluscum contagiosum (Molluscum contagiosum virus)
Protozoal infections:
Trichomoniasis (Trichomonas vaginalis
Fungal infection:
Candidiasis (Candida albicans)
Ectoparasites:
Pediculosis pubis (Phthirus pubis) & Genital scabies (Sarcoptes scabiei)
Clinically:
Diseases manifested by discharges:
1. Gonorrhoea (Neisseria gonorrhoeae)
2. Non-gonococcal urethritis in man (Chlamydia trachomatis & HSV)
Diseases manifested by ulcer:
1. Syphilis (Treponema pallidum)
2. Herpes (HHV)
3. Chancroid (Haemophilus ducreyi)
4. Granuloma inguinale (Calymmatobacterium granulomatis )
Diseases manifested by lumps:
1. Lymphogranuloma venereum (Chlamydia trachomatis)
2. Molluscum contagiosum (one of the pox viruses)
3. Genital warts (Papilloma virus)
Vaginitis:
1. Trichomoniasis (Trichomonas vaginalis)
2. Vaginal thrush (Candida albicans)
3. Bacterial vaginitis (Gardnerella vaginalis)
Infestation with parasites:
1. Pediculosis pubis (Phthirus pubis)
2. Genital scabies (Sarcoptes scabiei)
Sexually transmissible but reproductive tract not infected:
HIV/AIDS, hepatitis B & C
Modes of transmission of STD:
1. Unprotected sexual intercourse (vaginal, anal or oral)
2. Mother-to-child transmission:
a. During pregnancy: HIV, syphilis
b. During delivery: Gonorrhoea, chlamydia, HIV
c. After birth: HIV (through breast feeding)
3. Transfusion of infected blood and blood products
4. Sharing of needle-syringe (IDU)
Behavioural factors responsible for STD:
1. Having multiple partner
2. Frequent partner change
3. Sex with casual partners
4. Sex with sex workers
Sociocultural factors responsible for STD:
1. Failure to follow ‘safer sex’ measures due to –
a. Lack of knowledge of safer sex
b. Lack of access to affordable condoms
C. Dislike of condoms
2. Delay in getting STD treatment due to –
a. Women with STI often have no symptoms
b. Appropriate health facilities may not be available or affordable
c. Health facilities may not have the necessary drugs
d. The ‘social stigma’; so the people want to hide STD and prefer alternate treatment.
3. Not taking the full, prescribed course of treatment due to –
a. Cost of treatment
b. Lack of proper counselling
c. Side effects of drugs
d. Symptoms resolve during the half way treatment
e. Failure to bring partner for treatment
Public health effect of STD:
1. PID & infertility
2. Adverse pregnancy outcomes – Stillbirth, LBW, pre-term birth, congenital infections
3. Long-term morbidity
4. Increased risk of HIV acquisition
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