A sexually transmitted disease (STD) or venereal disease (VD) is an illness that has a significant probability of transmission between humans or animals by means of sexual contact, including vaginal intercourse, oral sex and anal sex. Increasingly, the term sexually transmitted infection (STI) is used, as it has a broader range of meaning; a person may be infected, and may potentially infect others, without showing signs of disease. Some STIs can also be transmitted via use of an IV drug needle after its use by an infected person, as well as through childbirth or breastfeeding. Sexually transmitted infections have been well-known for hundreds of years.
Specifically, the term STD refers only to infections that are causing symptoms. Because most of the time people don’t know that they are infected with an STD until they start showing symptoms of disease, most people use the term STD, even though the term STI is also appropriate in many cases. Moreover, the term sexually transmissible disease is sometimes used since it is less restrictive in consideration of other factors or means of transmission. For instance, meningitis is transmissible by means of sexual contact but is not labeled as an STI because sexual contact is not the primary vector for the pathogens that cause meningitis. This discrepancy is addressed by the probability of infection by means other than sexual contact.
Prevention of STDs
- Avoid Contact: The most effective way to prevent sexual transmission of STIs is to avoid contact of body parts or fluids that can lead to disease transfer, but not necessarily any sexual activity with an infected partner. No contact equals no risk—not all sexual activities involve contact, such as cybersex, phonesex or masturbation from a distance are methods of avoiding contact.
- Get Tested: Ideally, both partners should get tested for STIs before initiating sexual contact or if a partner engaged in contact with someone else, but even then, certain STIs, particularly certain persistent viruses like HPV, may be impossible to detect with current medical procedures as they may be asymptomatic. Prevention is also key in addressing viral STIs such as HIV and herpes, as they are currently incurable.
- Vaccines: Many diseases that establish permanent infections can occupy the immune system such that other diseases become more easily transmitted. Vaccines are available that protect against some viral STIs, such as Hepatitis B and some types of HPV. Vaccination before initiation of sexual contact is advised to assure maximal protection.The Innate immune system led by defensins against HIV can prevent transmission of HIV when viral counts are very low, but if busy with other viruses or overwhelmed, HIV can establish itself. Certain viral STIs also greatly increase the risk of death for HIV infected patients.
- Condoms: Condoms only provide protection when used properly as a barrier over a certain area. Uncovered areas are still susceptible to many STDs. In the case of HIV, sexual transmission routes almost always involve the penis, as HIV cannot spread through unbroken skin, thus properly shielding the penis with a properly worn condom from the vagina and anus effectively stops HIV transmission.A female condom is a device that is used during sexual intercourse to prevent pregnancy and transmission of sexually transmitted infections (STIs—such as gonorrhea, syphilis and HIV). Female condoms are inserted into the vagina prior to intercourse. They may also be used for anal sex, although they are less effective.
- Dental Dam: A dental dam (originally used in dentistry) is a sheet of latex used for protection when engaging in oral sex. It’s typically used as a barrier between the mouth and the vulva during cunnilingus or between the mouth and the anus during anilingus.
- Medical Gloves: Medical gloves made out of latex, vinyl, nitrile or polyurethane may be used as an ersatz (inferior) dental dam during oral sex, or to protect the hands during mutual masturbation. Hands may have invisible cuts on them that may admit pathogens that are found in the reproductive fluids of the STD-infected. Although the risk of infection in this manner is thought to be low, gloves can be used as an extra precaution.
- Dildos and Sex Toys: Another way to avoid contact with blood and semen is penetration, but not by the penis, such as using (properly cleaned) dildos or other sex toys. If a sex toy is to be used in more than one orifice, a condom can be used over it and changed when the toy is moved. Fisting (penetration by the hand), has its own risks, but the risk of HIV transfer can be reduced by latex gloves or a condom. Pegging, female-to-male anal sex with a strap-on dildo, as promoted by sex educator Carol Queen does not involve fluid transfer.
Treatment of STDs
Gonorrhea, Chlamydia and Nongonococcal or Nonspecific Urethritis (NGU/NSU)
- Take all the medication prescribed for you exactly as instructed.
- Return for a test in 2 weeks. If you stop too soon, you might still have the infection and not know it. It could spread to other parts of your body or to your sexual partners.
- Inform recent partners that they need to get checked to see if they also need treatment.
HIV (AIDS)
- There is no cure for HIV (AIDS). But you can learn how to strengthen your immune system and there are medications that slow the progression of the disease. Many infected for 10 or more years still feel well.
- Find out about classes, books, support groups and clinics specializing in HIV (AIDS) information and care in your area.
Hepatitis A, B and C
- Rest is the only treatment.
- People with hepatitis need to eat well and to avoid drugs and alcohol that damage the liver. In most cases, recovery is complete in 3-16 weeks. In more severe cases, complete bed rest and hospitalization might be necessary.
- Inform recent partners that they need to get checked to see if they also need treatment.
- Get the hepatitis B vaccine if you haven’t already been exposed to the virus!
Syphilis
- Treatment depends on the stage of the infection, but usually some form of penicillin is required to destroy all the bacteria.
- Flu-like symptoms often occur for several hours or days right after receiving penicillin.
- Inform all sexual partners during the last three months that they need to get checked to see if they also need treatment.
Herpes
- There is no cure for herpes.
- Acyclovir can reduce the severity and frequency of outbreaks for some people.
- Avoid heat and friction when blisters are present. Wear loose underwear.
- Drying agents or aspirin might help.
- Call the Herpes Hotline to learn more.
- Inform recent partners to get checked if they have sores or blisters appear.
Genital Warts
- Genital warts cannot be cured. Even after the wart tissue is destroyed, the virus remains and warts can reappear months or years later.
- A variety of ways can be used to destroy the wart tissue: Acid, freezing, burning and cutting are frequently used.
- Usually, you will need to return for several treatments. Where tissue was destroyed, a scab will form that will fall off after a few days, occasionally leaving a small scar. While it heals, keep it clean by bathing with mild soap and warm water.
- Inform recent partners that this disease is very infectious and to make sure they get checked. Women will need a cervical (vaginal) exam and possibly a pap smear.
Lice and Scabies
- Lice: Permethin 1% (Nix) shampoo is left on for 10 minutes then thoroughly rinsed off. Do not let it get in the eyes.
- Scabies: Gamma benzene hexachloride 1% (Lindane) lotion is spread thinly on dry skin and left on for 8-12 hours before rinsing it off.
- Remove lice/nits from eyes with tweezers; no medication should be used near the eyes.
- For both: Clothing and bed linen used in the past two weeks should be washed in hot water and/or dried in a hot cycle, or dry-cleaned.
- Hydrocortisone cream or other soothing lotions may be used for the itching that might persist for a few days after treatment.
- Treat bed partners and any house mates who also have symptoms.
Any organization or workplace should consider all the elements of an STD program discussed in the above guidelines. However, the examples provided are sometimes feasible only within a large organization or workplace. Monitoring and evaluation will involve different indicators to those used by larger organizations that provide services such as STD treatment and diagnosis.
On a more individual basis, STD treatment and prevention are more the couple’s prerogative than anything else, but it certainly wouldn’t hurt to practice proper, hygienic and protected sex instead of waiting for the STD to infect you. Contraceptives, birth control methods and vaccination can mean the difference between a potentially embarrassing and painful condition and a healthy, carefree and responsible sex life.
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