Sexually Transmitted Diseases
A sexually transmitted disease (STD) is a disease caused by a pathogen
(i.e., a disease-causing virus, bacterium, parasite, fungus) that is spread
from person to person primarily through sexual contact. STDs can be painful,
irritating, debilitating, and life threatening. More than twenty sexually
transmitted diseases have been identified.
Incidence and Prevalence
STDs occur most commonly in sexually active teenagers and young adults,
especially those with multiple sex partners. An estimated 200 to 400 million
people worldwide are infectedórepresenting men and women of all economic
According to the U.S. Department of Health and human Services, in the
United States more than 13 million people are infected each year and more
than 65 million have an incurable STD. Generally, STD incidence has declined
in the United States over the past 15 years, although rates among certain
populations, including men who have sex with men, have increased.
Most STDs cause relatively harmless disease, producing few symptoms or no
symptoms. However, some produce persistent asymptomatic or minimally
symptomatic disease (e.g., chlamydia). Some people carry the disease for
days or weeks, while others carry the disease for longer periods, even for
life. During this time, an infected individual, or carrier, can
In persistent infection, the pathogen evades detection by the
immune system and remains fairly inactive, causing no overt disease. This
inactivity is called latency. However, certain triggers (e.g.,
stress, immune suppression, injury) can reactivate latent pathogens.
In some cases, reactivated disease is asymptomatic (e.g., chlamydia); in
others, overt (e.g., genital herpes); and in still others, severe and even
fatal (e.g., HIV/AIDS).
Complications of STD infection include pelvic inflammatory disease
(PID) and cervicitis (inflammation of the cervix) in women, urethritis
(inflammation of the urethra) and prostatitis (inflammation of the prostate)
in men, and fertility and reproductive system problems in both sexes.
Possible consequences to a child infected by his or her mother,
while in the womb or during birth, include stillbirth, blindness, and
permanent neurological damage, depending on the disease.
A person infected with an STD is more likely to become infected with HIV,
and a person infected with HIV and another STD is more likely to transmit
Viral STDs, such as genital herpes (HSV) and human immunodeficiency virus
(HIV), cannot be cured, but symptoms can be managed with medication.
Bacterial STDs, such as gonorrhea and chlamydia, can be cured with
antibiotics. Fungal (e.g., vaginal yeast infection) and parasitic (e.g.,
trichomoniasis) diseases can be cured with antifungal and antihelminthic
agents, respectively. Early diagnosis and treatment increase the chances for
The only sure way to avoid becoming infected with an STD is monogamy with
an uninfected partner. It is important for partners to discuss their sexual
and STD history before having sex. Prevention is possible only if sexually
active individuals understand STDs and how they are spread.
The risk for transmission is dramatically reduced with the use of
condoms. The following behaviors and conditions can increase the risk for
- 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
- Tampon use (Tampons can cause vaginal dryness and cellular
abnormalities. Sanitary napkins, either disposable or washable cotton
pads, are recommended.)
- Vaginal dryness (Water-based lubricant is recommended.)
If you suspect you have an STD, see your physician immediately.