Sexually Transmitted Disease (STD) Facts, Complications and Prevention

Sexually Transmitted Disease (STD) Facts

• Sexually transmitted infections (STIs) are mostly spread from one infected person to another through sexual intercourse. Some infections may also be transmitted from mother to child during pregnancy and childbirth. Another way that infections are passed on is through the sharing of blood products or tissue transfers. Some diseases caused by STIs include syphilis, AIDS and cervical cancer.

• STIs often exist without symptoms, particularly in women. Thus, men and women with sexual partners who have STI symptoms should seek care regardless of a lack of signs. Whenever an infection is diagnosed or suspected, effective treatment should be provided promptly to avoid complications.

• STIs disproportionately affect women and adolescent girls. Every year, one in 20 adolescent girls gets a bacterial infection through sexual contact, and the age at which infections are acquired is becoming younger and younger. Improving awareness and knowledge of STIs and how to prevent them among adolescents should be part of all sexual health education and services.

• Sexually transmitted infections are important causes of Fallopian tube damage that lead to infertility in women. Between 10% and 40% of women with untreated chlamydial infections develop symptomatic pelvic inflammatory disease. Post-infection damage of the Fallopian tubes is responsible for 30% to 40% of female infertility cases.

• In pregnancy, untreated early syphilis is responsible for 1 in 4 stillbirths and 14% of neonatal (newborn) deaths. About 4% to 15% of pregnant women in Africa test positive for syphilis. Interventions to more effectively screen pregnant women for syphilis and prevent mother-to-child transmission of the disease could prevent an estimated 492 000 stillbirths per year in Africa alone.

• One of the most deadly sexually transmitted infections is the human papilloma virus (HPV). Virtually all cervical cancer cases are linked to genital infection with the virus. Cancer of the cervix is the second most common cancer in women, with about 500 000 new cases and 250 000 deaths each year. The new vaccine that prevents the infection could reduce these cervical cancer-related deaths.

• When used properly and consistently, condoms are one of the most effective methods of protection against STIs, including HIV infection. Although the female condom is effective and safe, it is not as widely used in national programmes because of its higher cost when compared to male condoms.

• The partner notification process, which is an integral part of STI care, informs sexual partners of patients about their exposure to infection so that they can seek disease screening and treatment. Partner notification can prevent reinfection and reduce the wider spread of infections.

• Social or economic conditions, and some sexual behavior increase a person's vulnerability to STIs. Populations most-at-risk for sexually transmitted infections vary from setting to setting, depending on local culture and practices. Interventions to prevent and care for STIs should be intensified for such populations, while ensuring that services minimize potential stigmatization and discrimination.

• A global strategy to accelerate prevention and control of STIs was developed by WHO through broad consultation among Member States and partners, and then endorsed by the World Health Assembly in May 2006. To build momentum and effectiveness, the 10-year plan includes technical and advocacy components that can be adapted for use around the world.

Complications and Consequences of STD

STDs often exist without symptoms. In women with gonococcal and/or chlamydial infections there may be no symptoms in up to 70% of cases. Both symptomatic and asymptomatic infections can lead to the development of serious complications. The most serious complications and sequelae (long-term consequences) of untreated STDs tend to be in women and newborn babies. These can include cervical cancer, pelvic inflammatory disease (salpingitis), chronic pelvic pain, fetal wastage, ectopic pregnancy and related maternal mortality. Chlamydial infections and gonorrhoea are important causes of infertility, particularly in women, with far-reaching social consequences. Chlamydial infection is an important cause of pneumonia in infants. Neonatal gonococcal infections of the eyes can lead to blindness. Congenital syphilis is an important and significant cause of infant morbidity and mortality. In adults, syphilis can cause serious cardiac, neurological and other consequences, which can ultimately be fatal. Some types of genital warts lead to genito-anal cancers. Cervical cancer is one of the commonest causes of death in women in developing countries.

Prevention of STD

The objectives of STD prevention and care are to reduce the prevalence of STDs by interrupting their transmission, reducing the duration of infection and preventing the development of complications in those infected. Primary prevention, which is concerned with the entire community, curbs the acquisition of infection and resulting illness. It can be promoted through health education, and involves practices such as safer sex behavior, including the use of condoms, and abstinence from sex. Primary prevention messages apply equally to HIV and other STDs. Secondary prevention involves treating infected people. Except for HIV and the viral STDs, treatment cures the disease and interrupts the chain of transmission by rendering the patient non-infectious. The prevention of STDs is a cost effective option for countries to invest in. With a common currency for measuring cost and a unit for measuring health effects, different interventions can be compared by what it costs to achieve one additional year of healthy life. Outcomes are measured in the same unit of disability-adjusted life years (DALYs) that is used to estimate the burden of disease. The ratio of cost to effect, or the unit cost of a DALY, is called the cost-effectiveness of the intervention; the lower that number, the greater the value for money offered by the intervention. Treatment of STDs is often highly cost effective in its own right. It becomes even more cost-effective when the benefits of reduced HIV transmission are added. Curing each case of gonorrhoea among people who are more likely to acquire and transmit the infection, such as sex workers and their clients, saves 120 DALYs, at a cost of well below US$ 1.00 per DALY gained when the benefits of fewer secondary cases and the reduced risk of HIV transmission are included.

Article source: WHO | World Health Organiztion