Sexually transmitted infections

Some of the most common STDs: From top to left: gonorrhea, syphilis, human papiloma, herpes and candidiasis.

Sexually transmitted infections (STIs), also formerly known as sexually transmitted diseases (STDs) or as venereal diseases, are a set of infectious-contagious clinical conditions that are transmitted from person to person through sexual contact that occurs almost exclusively during sexual intercourse. However, they can also be transmitted by use of contaminated syringes or by contact with blood or other secretions, and some of them can be transmitted during pregnancy, childbirth or breastfeeding, from mother to child.

Most sexually transmitted diseases are caused by two types of germs: bacteria and viruses, but some are also caused by fungi and protozoa.

Caution

• Timely sex education to learn about diseases of this type and how to get contagion.
• Hygiene of sexual organs; daily bath with soap and careful drying of the genitals should be practiced.
• Use of protective mechanisms such as condom or condom when sexual intercourse occurs.

Epidemiology

Incidence rates of STIs (Sexually Transmitted Infections) remain high in most parts of the world, despite diagnostic and therapeutic advances that can quickly render patients with many STIs non-contagious and cure most. In many cultures, changing sexual mores and the use of the oral contraceptive have removed traditional sexual restrictions, especially for women, yet both health professionals and patients find it difficult to discuss sexual problems openly and honestly. Additionally, the worldwide spread of drug-resistant bacteria (eg, penicillin-resistant gonococci) reflects the misuse (overuse) of antibiotics and the spread of resistant copies in mobile populations. The effect of travel becomes more evident with the rapid spread of the AIDS virus (HIV-1) from Africa to Europe and the Americas in the late 1970s.^{[citation needed ]}

STI prevalences frequently observed in sexually active adolescents with and without lower genital tract symptoms include:

• Chlamydia (10-25 %),
• gonorrhea Neisseria (3-18 %),
• syphilis (0-3 %),
• Trichomonas vaginalis (8-16 %), and
• Herpes simple virus (2-12 %).

Among young adolescents without symptoms of urethritis, isolated rates include C. trachomatis (9-11%) and Neisseria gonorrhea (2-3%).^{[citation needed]}

In reports presented by the World Bank, The Global Women's Institute (George Washington University) and the Inter-American Development Bank, the relationship between violence against women and girls and the increased risk of contracting STIs, this is also associated with unwanted pregnancies, depression and other collateral damage.

In 1996, the WHO estimated that more than a million people were infected daily. About 60% of these infections occur among people under 25 years of age, and 30% of these are under 20 years of age. Between the ages of 14 and 19, STIs occur more frequently in girls than boys in a ratio of almost 2:1; this equalizes in both sexes by age 20. An estimated 340 million new cases of syphilis, gonorrhea, chlamydia, and trichomoniasis occurred worldwide in 1999.^{[citation needed]}

Currently, there are about 400 million new cases worldwide each year. 90% between the ages of 15 and 30, and especially in those under 25, single and sexually active, in addition to children born infected. Of those 400 million, almost 300 million are from syphilis, gonorrhea and AIDS.^{[citation needed]}

Prevention

U.S. propaganda poster (c. 1942-1945), possibly developed by an agency of the U.S. government, and aimed at soldiers and sailors of the Second World War who appealed to their patriotism to urge them to protect themselves. The text includes the term venereal diseases (doctor name used at that time) and says: "(She) may seem clean, BUT... the girls that leaguesThe ones you find on the street, the prostitutes... SYFILIS and GONORREA DISEMINATE. You will not be able to defeat (the powers of the Axis) if you contract venereal diseases." Women's images were used to capture the attention of citizens against infections.

• To maximize the daily hygiene of external sexual organs to prevent colonization by microorganisms that can cause infections and irritations.
• Review sexual organs periodically to detect possible alterations, such as swelling, redness, ulcers, secretions, intense smells, etc.
• Go to the doctor whenever there is any alteration.
• Report on modes of transmission, symptoms and consequences of sexually transmitted diseases.
• Use condoms whenever sporadic sexual intercourse is maintained or with unknown persons. In terms of AIDS, moreover, you should not share utensils that can cause skin and mucous lesions: syringe, razor blades, toothbrushes, etc.
• Always communicate the presence of any sexually transmitted disease.
• Avoid sexual intercourse if you have any sexually transmitted disease to prevent other people from being infected.
• Go to health centres or family planning where necessary, both where fertility problems exist and when contraceptive methods are desired.
• Know, accept and value the body.
• Avoid complexes of guilt or shame in sexual relations developed with love and respect for the couple.
• Respect all people regardless of their sexual orientation and value each of them according to their personal qualities and not their sexual preferences.
• Have confidence in the couple and talk to her about previous sexual relationships and possible sexually transmitted diseases.
• Regularly visit the doctor who specializes in STDs to detect possible diseases prior to treatment.

Limitation between couples

The risk of transmission is greatly reduced if both parties have received a medical examination, with a blood test, to find out that these infections do not exist in the person, and if couples are limited from now on to those who have had the same revision. In the United States there is a completely voluntary certificate in which doctors, under their own letterhead, certify that the named individual is free of sexually transmitted organisms. All the big pornography companies, which usually deny condom use, require this certificate. Even so, since the tests are not perfect and sometimes weeks have to pass after transmission for a positive result, the risk is greatly reduced, but not eliminated.

Monogamy is not theoretically a perfect solution. A virgin can have a sexually transmitted disease. They are transmitted, including the AIDS virus, from mother to child during childbirth. A monogamous couple, with both free of relevant microorganisms, is perfect. But a group of three or more is equally perfect, all checked out by doctors, with no sexual contact with anyone outside the group. Although you would think that a couple of only two is safer, it is not. There are many cases in which a supposedly monogamous couple becomes infected due to the lack (sex with a person without medical examination) of one of them. Sexual groups where everything is discussed are safer.^{[citation needed]}

Masturbation and phone sex are risk free, except emotional. Also abstinence: eliminating sex, sexually transmitted diseases are avoided.

Condom

Condoms or condoms provide protection when used correctly as a barrier to/from the area they cover. Uncovered areas are still susceptible to many STDs. An infected discharge in contact with a skin lesion that would lead to the direct transmission of an STD would not be considered “sexual transmission”, but could theoretically occur during sexual contact; this can be avoided simply by stopping sexual contact when you have an open wound.

Condoms are designed, tested, and manufactured not to fail if used properly, but they are not absolute safety.

Proper use requires:

• Do not put the condom too firm on the end, leaving 1 or 2 cm on the extremity for ejaculation. If the condom is placed very tight, it may fail.
• Use a new condom for every sexual encounter.
• Do not use a condom too loose, because it can make the barrier fail.
• Do not turn the condom after it has ended, even though there has been no ejaculation.
• Do not use condoms made with animal tissue, which protect against conception, but not against HIV and other STDs.
• Avoid leaving the condom in the heat because they can wear off.
• Avoid the use of oil-based lubricants (or anything that contains oil) with latex condoms, as oil can make them break.
• Avoid double use of condom, because friction between the two can make them break.

Prostitution: an important cause of sexually transmitted infections

Prostitution, due to the activities inherent to its exercise, exposes those who practice it to risks of all kinds, such as violence in its various manifestations, psychological effects due to social stigma and sexually transmitted infections (STIs) and viruses human immunodeficiency (HIV).

The attention paid to sexually transmitted diseases (STDs) in relation to prostitution is not something new, with HIV being the most recent problem from a medical point of view tied to discourses and moral practices on the use of the body as an economic activity.

When HIV was first identified, the culprits were immediately blamed on prostitutes, the potential carriers of a fatal disease. This signaling produced social effects —which were not positive in all cases— in people linked to sex work, responses of different proportions were developed around the world, from repressive measures to effective mobilizations of the community and public health programs.

Prostitution was judged as an inevitable evil, a social cancer and a disease of society, for this reason they fought to combat and eradicate it. It was perceived from different angles, on the one hand, it was an activity that violated the modest and traditional use of the body. On the other, its abolition was supported from the conception of the risk of paid sexual activity as it is a vehicle for sexually transmitted infections.

Sex work is considered work as long as it is carried out with the full consent of the person performing it, that is, as long as it does not have consequent economic needs of capitalism. Likewise, it is separated from the concept of trafficking in persons for the purpose of sexual exploitation. The rights of women engaged in sex work, international organizations and non-governmental organizations recognized the need to promote support and care services for sex workers in order to prevent more sexually transmitted infections.

On the other hand, it is normal that in adolescence, young people begin to show some curiosity about sexual relations, however, it is important to publicize the risks they run, since most of the time they are only taken in account pregnancies at an early age, neglecting the myriad of diseases that can be contracted by not protecting oneself. These different diseases can bring consequences of two kinds: psychological and physical. Among the psychological, feelings of undervaluation that can lead to self-harm or even suicide are taken as the most important, as are other mental illnesses such as neurosis and psychosis. In the physical part, the physical aspect must be taken into account. damage suffered by the genital organs and the body in general. Since some STDs can lead to irreparable damage to organs or even cancer. It is extremely important to emphasize the forms of prevention, among all, the one that will always be mentioned is abstinence as a 100% effective method, but even so, there are also less reliable methods, such as the female or male condom.

STI diagnostic tests

STI diagnostic tests can be done to look for just one of these infections or include several individual tests for a wide range of them, including tests for syphilis, gonorrhea, chlamydia, hepatitis, and HIV tests. However, there is no procedure that can be applied to detect the presence of absolutely all infectious agents, so it is important to know which of the different STIs each test is used for.

History of treatments

During this period, the importance of monitoring the tracks of infected people to treat STIs was recognized. Tracking the sexual partners of infected individuals, testing them to confirm if they were infected.

Sexual diseases

Gonorrhea

Gonorrhea is one of the most common sexually transmitted infections (STIs). It is caused by the bacterium Neisseria gonorrhoeae, which can easily grow and multiply in warm, moist areas of the reproductive system, including the cervix (opening of the womb), uterus (womb), and fallopian tubes. fallopian tubes (also called the oviducts) in women, and the urethra (urinary canal) in women and men. This bacterium can also grow in the mouth, throat, eyes, and anus.

Symptoms

In women:

• Unusual vaginal discharge.
• Unusual vaginal bleeding.
• Pain at the bottom of the abdomen.

The infected woman may have no symptoms or present slight discomfort when urinating or discharge.

In man:

• Pain when urinating.
• Purulent urethral secretion.
• Inflammation in the pelvis area, discomfort similar or attributable to the English nodes.

In the male, two to three days later, intense pain in the pelvic area elapses, presenting muscular discomfort when pressing on said area. In addition, symptoms may occur (pain when urinating, as it comes out through the urethra). Gonorrhea and chlamydial infection can cause infertility when treatment is not applied.

It differs from syphilis because the infections are not fatal, but they can be very painful and cause infertility.

Syphilis

It is a sexually transmitted infection caused by the bacterium Treponema pallidum. It is transmitted when you come in contact with the open wounds of an infected person. This disease has several stages: primary, secondary, latent, and tertiary (late). In the secondary stage, it is possible to get it by coming into contact with the skin of someone who has a skin rash caused by syphilis.

Symptoms

If it is not treated in time, the disease goes through four stages:

• Primary stage: the first symptom is a wound in the body part that came into contact with the bacteria. These symptoms are difficult to detect because they usually do not cause pain, and sometimes occur inside the body. A person who has not been treated can infect others during this stage.

• Secondary stage: arises about three to six weeks after the wound appears. An eruption will appear throughout the body, in the palms of the hands, in the soles of the feet or in some other area. Other possible symptoms are: mild fever, lymph nodes inflammation and hair loss.

• Latent Stage: If it is not diagnosed or treated for a long time, syphilis enters a latent stage, in which there are no notable symptoms and the infected person cannot count on others. However, one third of the people at this stage are getting worse and going to the tertiary stage of syphilis.

• Tertiary Stage: This stage can cause serious problems such as mental disorders, blindness, heart anomalies and neurological disorders. At this stage, the infected person can no longer transmit the bacteria to other people, but continues in an indefinite period of deterioration.

Human Papilloma

It is an infectious disease caused by HPV (human papillomavirus). It is mainly transmitted by sexual intercourse, although it can also be transmitted by non-penetrative genital rubbing and through childbirth. They are not transmitted by the use of saunas or swimming pools, nor by sharing personal hygiene items. It appears on the skin of the genital areas in the form of warts. The lesions are visible to the naked eye or can be diagnosed by observing tissue under a microscope.

Symptoms

The most important symptoms that suggest the presence of human papillomavirus are small warts in the anogenital area: cervix, vagina, vulva and urethra (in women) and penis, urethra and scrotum (in men). When warts appear on the external genitalia, there may also be itching and bleeding if these are exposed to rubbing. They can vary in appearance (flat warts are not visible or pointed warts are visible), in number and in size, so a specialist is needed for their diagnosis. The most aggressive types of human papillomavirus can cause changes in the Pap smear, which reflects that there are squamous intraepithelial lesions on the cervix (HPV-infected areas that can cause cancer).

HIV

The human immunodeficiency virus (HIV) is responsible for acquired immunodeficiency syndrome (AIDS) and attacks T-4 lymphocytes, which are a fundamental part of the human immune system. As a consequence, the body's ability to respond to opportunistic infections caused by viruses, bacteria, protozoa, fungi and other types of infections decreases.

The most common cause of death among people living with HIV is Pneumocystis jiroveci pneumonia, although the incidence of certain types of cancer, such as B-cell lymphomas (non-abdominal lymphoma), is also high. Hodgkin) and Kaposi's sarcoma. Neurological complications, weight loss, and physical deterioration of the patient are also common. Mortality decreased a lot with the invention of antiretroviral drugs.

HIV can be transmitted sexually (vaginally or anally) through the exchange of vaginal or rectal fluids or semen, as well as through contact with pre-ejaculatory fluid during sexual intercourse or through blood transfusions. An HIV-infected mother can also infect the child during pregnancy through the placenta or during childbirth and lactation, although there are treatments to prevent this. After infection, it can take up to 10 years for AIDS to be diagnosed, which is when the immune system is severely damaged and unable to respond effectively to opportunistic infections.

It is very important to note that a person infected with HIV may or may not develop AIDS. Many patients who have been diagnosed with HIV seropositive go long periods of time without developing immunodeficiency and it is a condition that can be overcome. The AIDS condition is not permanent.

There are medications to prevent HIV if you are exposed to it:

• PrEP (pre-exposure prophylaxis): indicated for people who do not have HIV, but have a high risk of contracting it, is taken daily and reduces the risk of contracting it, is indicated for couples in which one or both is HIV positive, individuals who possess multiple partners, a couple with multiple partners or a couple with an unknown HIV status, or individuals who share needles to inject drugs.

• PEP (post-exposure prophylaxis): indicated for individuals who believe they have been exposed to HIV, is indicated only for emergency situations and should be taken within 72 hours of possible HIV exposure.

Symptoms

The symptoms of AIDS in adolescents can be the same as in children and can also be more like the symptoms that often occur in adults with the syndrome. Some adolescents and adults may develop an increased sperm secretion illness as well as a flu-like illness within a month or two after exposure to HIV, although many people do not develop any symptoms when infected. Also, the symptoms usually clear up within a week to a month, and they are often mistaken for symptoms of another viral infection. Symptoms may include:

• fever
• headache
• general discomfort
• depression
• infertility
• vomiting
• diarrhea

Transmission routes

The three main routes of HIV transmission are:

• Sexual (sexual act without protection). The transmission occurs by the contact of secretions infected with the other person's genital, rectal or oral mucosa.
• Parenteral (by blood). It is a form of transmission through infected syringe that is given by the use of intravenous drugs or through health services, as has sometimes occurred in poor countries; also in people with hemophilia who have received an infected blood transfusion or infected products derived from the blood; to a lesser extent, health workers who are exposed to the infection in a work accident, such as can occur if a wound enters into contact;
• Vertical (from mother to child). The transmission can occur during the last weeks of pregnancy, during delivery or when breastfeeding the baby. Of the three, childbirth is the most problematic. Currently in developed countries the vertical transmission of HIV is fully controlled (as long as the mother knows that she is a carrier of the virus), as since the start of the pregnancy (and in certain cases even before) the pregnant woman is given an Antiretroviral Therapy of Great Activity (TARGA), especially indicated for these situations; the delivery is usually done by caesarean, the production of milk (and with this the new breastfeeding) is suppressed.

Chlamydia

Chlamydia is a sexually transmitted disease (STD). It is caused by the bacterium Chlamydia trachomatis. It tends to affect women more than men.

In women

Chlamydia usually attacks the fallopian tubes and is mostly asymptomatic, so it can easily go unnoticed. Many times this disease is confused with cystitis or urinary infection due to the symptoms that a woman may present such as a burning sensation when urinating. Normally when chlamydia is detected it is easy to cure. Treatment is mainly based on antibiotics. However, being a very silent disease on many occasions it is not detected and not treated. In these cases, it can affect female fertility, making it much more difficult to get pregnant. Although it is also true that many times, even with treatment, the disease may not be completely eliminated.

List of STIs

First recognized STIs

• chlamydiasis and venereal lymphogranuloma (infection by Chlamydia trachomatis)
• gonorrhea
• syphilis
• Chlamydia

Recently Recognized STIs

• candidiasis or aftas (infection by Candida albicans)
• Mycoplasma genitalium (uretritis no gonococcic)
• retrovirus such as HIV, HTLV or XMRV
• ureaplasma
• acuminate condiloma (genital warts), caused by human papillomavirus

Infections mainly transmitted sexually

• chancroide
• donovanosis or inguinal granuloma
• ftiriasis (ladillas)
• herpesvirus (eight known types)
• genitourinary tract infection
• congenital syphilis, early syphilis and late syphilis
• tricomoniasis

Infections occasionally transmitted sexually

Many non-sexually transmitted infections can also be transmitted sexually, depending on the couple's level of intimacy:

• campilobacteriosis
• cytomegalovirus
• cryptospordium
• Gardnerella vaginalis (also Haemophilus)
• giardiasis
• hepatitis B

• fungal infection
• listeriosis
• meningocococemia
• genital mycoplasms
• contagious mollusk
• human papillomavirus (HPV)
• salmonelosis
• mycobacteriosis
• sarna
• vaginitis
• bacterial vaginosis
• hepatitis C