Sexually Transmitted Infections: A Threat that is Preventable

 

In a revealing interview of an A-list actor of the cause of his throat cancer, which he initially said is a sexually transmitted infection (STI) but denied by his agent, the issue on the threat of STIs in the community has stirred public curiosity about the harm of these infections. Although public education and understanding has been increased over time, it is still a long way to its eventual decline. Proof of this is the World Health Organisations’ estimate in 2005 that there were about  448 million new cases of curable STIs that occur yearly amongst adults aged 15-49 years worldwide.1

 

* All four STIs cases are in millions. Data is taken from the World Health Organization. 1

 

As the name implies, STIs are diseases that are acquired through various sexual activities. There are numerous infections that are transmitted sexually, and the most common are Chlamydia, syphilis, gonorrhoea and Trichomoniasis. Other important STIs are Human Immunodeficiency Virus (HIV), Hepatitis B, Human Papilloma Virus (genital warts) and Herpes Simplex Virus types 1 and 2 (genital herpes).

 

STIs are preventable diseases. They can be prevented by abstaining from any forms of sexual intercourse (vaginal, oral or anal) or having sexual intercourse with a mutually monogamous partner. The use of male latex condoms and female condoms also decreases the risk of STIs when used consistently and correctly.

 

Besides the aforementioned methods, one of the most effective ways to prevent some STIs is through vaccination. Vaccines for Hepatitis B and some types of genital warts have already been marketed worldwide. It is highly recommended that sexually active people get the vaccines, as they also lessen the risk of having cancers associated with these two forms of viruses. Hepatitis B virus is an important cause of liver cancer in the long-term especially amongst the chronic carriers of the virus; whilst some types of HPV are directly linked to cervical cancer as well as oral and anal cancers.

 

In a recent Australian study, researchers from the Kirby Institute of the University of New South Wales found that there was a decrease of more than 90% in the diagnosis of genital warts by the fifth year of the national quadrivalent HPV vaccination programme which was rolled out in 2007 in comparison to the years prior to the vaccination programme.2

 

 

What symptoms should you look out?

Symptoms of STIs include the following:

  • vaginal or penile discharge
  • groin swelling
  • swelling of the scrotum
  • lower abdominal pain
  • painful urination
  • rashes in the groin or sexual organ or other parts of the body

(Note that these symptoms are highly suggestive of a STI if a patient has had a previous or recent unsafe sexual practice.)

 

It is also important to consider that STIs may sometimes be asymptomatic (without symptoms). For this reason, people with risky sexual behaviours (e.g. multiple sexual partners) need to consider preventive measures outlined above.

 

Patients who have symptoms need to consult their medical provider for prompt diagnosis and treatment of the STI. Vital to avoiding late complications of STIs, such as infertility in both genders, is early detection and management.

 

 

Can STIs be screened?

Yes, screening for STIs is an important method for early detection especially when a patient has had a previous or recent unsafe sexual encounter to a partner who has STI or a partner of unknown status. It is also recommended for people who have risky sexual behaviours to consult their medical practitioners in order to discuss STI screening.

 

Screening is also done in women who are contemplating having or expecting a baby. The need to screen a ‘would-be’ and an expectant mother is to avoid or lessen the risk of transmission from mother to foetus, and to prevent demise of the foetus by treating the infection, if the screening comes out positive with any STI. Foetuses can be affected with untreated STIs through two possible ways. One is by retrograde (upward) spread of the infection, and also by transplacental transmission (infection being transferred from the mother to the foetus through the placenta).

 

 

References:

1.        World Health Organisation. Prevalence and incidence of selected sexually transmitted infections, Chlamydia trachomatis, Neisseria gonorrhoea, Syphilis and Trichomonas vaginalis: Methods and results used by WHO to generate 2005 estimates. Geneva, Switzerland. 2011.

2.        Ali H, Donovan B, Wand H, Read TRH, Regan DG, Grulich AE, Fairley CK, Guy RJ.Genital warts in young Australians five years into national human papillomavirus vaccination programme: National surveillance data. BMJ 2013;346:f2032.