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Sexually transmitted diseases (also called STDs, or STIs for sexually transmitted infections) are infections that can be transferred from one person to another through sexual contact.

Everyone, young or old, rich or poor, sexually active or not, needs to know a few important facts about sexually transmitted diseases.

1What are STD?

Sexually Transmitted Diseases are infections that are passed from person to person through sexual contact, including:

• Vaginal sex – the man’s penis in the woman’s vagina.
• Anal sex – the man’s penis in the partner’s anus (the partner can be either male or female).
• Oral sex – the man’s penis in the partner’s mouth, or the partner’s mouth or tongue in the woman’s vagina.
• Oral-anal sex – one partner’s mouth or tongue on the other partner’s anus.

Sexually transmitted diseases are caused by different infectious microorganisms including bacteria, viruses and parasites, which are transmitted through semen, vaginal fluid, blood or other body fluids during sexual activity.

2There is no immunity to STD

If you get an STD once, you can get it again. Moreover, you can have more than one STD at a time. Hepatitis B is the only STD for which a licensed vaccine is available.

3The incidence of STD's is rising

Even with all the education and resources available today, sadly, the number of cases of STDs continues to rise dramatically worldwide.

This is happening in part because in the last few decades young people have become sexually active earlier yet are marrying later. In addition, divorce is more common. The net result is that sexually active people are more likely to have multiple sex partners and are more likely to acquire STD's.

4Half of all STDs occur in people younger than age 25

Although teens and young adults represent only 25% of the sexually active population, 15–24-year-olds account for nearly half of all STI diagnoses each year. Adolescents are more concerned about unwanted pregnancy than with contracting an STD.

5"No symptoms" does not mean "no STD"

Most STDs can be "silent," causing no noticeable symptoms. These asymptomatic infections can be diagnosed only through testing. So you can be infected and infect someone else without knowing it.

This is especially true in women. If symptoms develop, they may be confused with those of other diseases not transmitted through sexual contact. In fact, about 70% of chlamydial infections in women, and 50% in men are without acute symptoms.

6There is currently no cure for STDs caused by viruses

Viral STDs (such as genital warts, herpes, hepatitis B) can not be cured, but their symptoms can be treated. There is no way to get any of these viruses out of a person's body once he or she has become infected.

7Bacterial STDs are curable

Bacterial STDs, such as gonorrhea, syphilis, and chlamydia, are cured with antibiotics.

8Women are more likely to have serious health problems from STDs

Health problems caused by STD's tend to be more severe and more frequent for women than for men. This is because of the increased frequency of asymptomatic infections. As a result many women do not seek care until serious problems develop.

9Consequences of STDs

It is quite true that most sexually transmitted infections can be completely cured if they are caught at an early stage, and that the treatment may be as simple as a course of antibiotics. However, if left untreated, STIs can pose a long-term risk to your health and fertility. And the sad fact is that certain STDs are eventually fatal.

While each STD causes different health problems, overall, they can cause:

• Ectopic or tubal pregnancies which can be fatal to the mother and are always fatal to the unborn baby.
• Babies born to women with sexually transmitted diseases may suffer death or severe damage as a result of the mother's STD.
• Sometimes sexually transmitted diseases cause damage to other organs including the heart, kidneys, and brain.
• 10 to 20% of women with gonorrhea and chlamydia develop one of the most serious complications, pelvic inflammatory disease (PID).
• Women who have current or prior history of certain sexually transmitted diseases such as PID have a significant chance of experiencing infertility. Up to 40% of women with untreated chlamydia infections develop PID, and 20% of those may become infertile.
• In men, untreated STD can cause epididymitis, a painful infection in the tissue surrounding the testicles that can result in infertility.

10Certain STDs can be transmitted through Non-Sexual contact

Usually direct sexual contact, such as vaginal, oral or anal sex, is required to transmit the infection. However, some STDs can be passed in non-sexual ways, either with body-to-body contact or surface-to-body contact:

• Syphilis
  The spirochete bacterium that causes syphilis can be transmitted by direct contact with the open sores which often characterize the disease during its early stages. Kissing can spread the disease under these conditions. Unlike most STDs, primary or secondary syphilis also can be transmitted by nonsexual contact. For example, if a person with a cut or break in the skin on his hand shakes hands with an infected person who has an open sore on his hand, infection can result. Though this is rare, it points out the extremely infectious nature of the disease at different stages.
• Herpes
  Herpes can invade the body virtually anywhere an open herpes sore comes in to contact with a break in the skin. For example, a person can become infected by kissing someone with a herpes cold sore.
• Trichomonas
  Trichomonas vaginalis, the parasitic protozoan that causes trichomoniasis ("trich"), is capable of surviving for some hours outside the body in bodily fluids, damp towels or bedding. In rare cases it has been known to be spread by mutual masturbation, when bodily fluids from one partner come in contact with the other partner's genitals.
• Parasitic insects
  Parasitic insects, such as crab lice (Pediculosis pubis) and scabies mites, though typically transmitted through sexual contact, are highly mobile. A person can acquire crab lice from bedding, clothing or toilet seats, and instances of scabies infection through contaminated clothes or bedding have been authenticated.

Babies can contract many different STDs at birth from their infected mothers.

11Condoms are very effective, but don't offer 100% protection from STD

Remember, although condoms can help reduce your exposure to STDs, they are not foolproof. Condoms will not protect you from some STDs, because the condom may not cover the infected area. Examples of some infections that can be transmitted despite religious condom use are:

• Herpes Simplex Virus (genital herpes)
• Human Papilloma Virus (genital warts)
• Syphilis
• Chancroid

But because condoms cannot protect against every form of STI, it is important to limit the number of sexual partners you have, and to be tested for STIs on a regular basis.

12Rigorous antibiotic treatment does not insure the cure

The only way to know if the sexually transmitted disease is no longer present is to follow-up with your doctor for retesting and examination. Follow-up is extremely important because a person may have a resistant strain of the infection and could still have the infection despite adequate treatment with antibiotic.

13Signs and symptoms related to STD

You may have an STD if you have any of the following symptoms:

• Pain or discomfort when urinating
  This is common for chlamydia, gonorrhoea, genital herpes.
• Itchiness or irritation in the genital area
  This is common for pubic lice (crabs), scabies, herpes.
• Lumps on the genitals
  This is common for genital warts, molluscum contagiosum.
• Discharge from the genitals (unusual or bad-smelling)
  Discharge from the penis is often caused by gonorrhoea and chlamydia or non-specific urethritis.
  Discharge from the vagina is more commonly associated with trichomoniasis, gonorrhoea and chlamydia.
• Genital sores
  Sores around the genitals may be the result of herpes, syphilis.

14STD disparities: rates tend to be higher among African Americans

Although STDs are widespread across racial and ethnic groups, the rates tend to be higher among African Americans than white Americans.

Blacks remain the group most heavily affected by gonorrhea. In 2004, the gonorrhea rate among blacks was 19 times the rate among whites.

The rate of chlamydia among black women was nearly eight times the rate among white women. The rate among black men was more than 11 times that of white men1.

15Behaviors and conditions that can increase the risk for STDs

The following behaviors and conditions can increase the risk for STDs:

• Engaging in sexual activity when either partner has unhealed lesions (e.g., genital herpes sores, genital warts).
• Enema or rectal douching before rectal intercourse.
• Rectal or vaginal irritation or infection.
• Sexual activity that may damage the mucosal lining of the vagina or rectum.
• Tampon use can cause vaginal dryness and cellular abnormalities.
• Vaginal dryness.

16Non-STI infections that may be transmitted via sexual contact

Some bacteria, viruses, and parasites that are usually transmitted nonsexually can sometimes be transmitted during sex:

• Amebiasis
• Salmonellosis
• Shingellosis
• Giardiasis
• Typhoid fever
• Yeast infections

17The most reliable way to avoid getting an STD is to not have sex

Obviously, abstinence (not having oral, vaginal, or anal sex) is the best way to prevent STDs. This is OK for some, but not realistic for most people.

Failing that, the next surest way to is to limit the sexual relationship to a mutually monogamous relationship with a partner who has been tested and does not have an STI.

And the third way to protect yourself from sexually transmitted diseases is to use condoms consistently and correctly.

• 1. Centers for Disease Control and Prevention (CDC), Trends in reportable sexually transmitted diseases in the United States, 2004: National surveillance data for Chlamydia, Gonorrhea, and Syphillis. Atlanta: CDC, 2005.