Sexually Transmitted Diseases

All sexually transmitted diseases have certain elements in common. They are most prevalent among teenagers and young adults, with nearly 66% occurring in people under 25. In addition, most can be transmitted in ways other than through sexual relations. For example, AIDS and Hepatitis B can be transmitted through contact with tainted blood, but they are primarily transmitted sexually. In general, sexual contact should be avoided if there are visible sores, warts, or other signs of disease in the genital area. In some cases the risk of developing most sexually transmitted diseases is reduced by using condoms and in all cases limiting sexual contact.

Sexually transmitted diseases vary in their susceptibility to treatment, their signs and symptoms, and the consequences if they are left untreated. Some are caused by bacteria. These usually can be treated and cured. Others are caused by viruses and can typically be treated but not cured.

Bacterial sexually transmitted diseases include syphilis, gonorrhea, chlamydia, and chancroid. Syphilis is less common than many other sexually transmitted diseases in the Unites States, with 134,000 cases in 1990. The disease is thought to be more difficult to transmit than many other sexually transmitted diseases. Sexual partners of an individual with syphilis have about a 10% chance of developing syphilis after one sexual contact, but the disease has come under increasing scrutiny as researchers have realized how easily the HIV virus which causes AIDS can be spread through open syphilitic chancre sores.

Gonorrhea is far more common than syphilis, with 750,000 cases of gonorrhea reported annually in the United States. The gonococcus bacterium is considered highly contagious. Public health officials suggest that all individuals with more than one sexual partner should be tested regularly for gonorrhea. Penicillin is no longer the treatment of choice for gonorrhea, because of the numerous strains of gonorrhea that are resistant to penicillin. Newer strains of antibiotics have proven to be more effective. Gonorrhea infection overall has diminished in the United States, but the incidence of gonorrhea among black Americans has increased.

Chlamydia infection is considered the most common sexually transmitted disease in the United States. About four million new cases of chlamydia infection are reported every year. The infection is caused by the bacterium Chlamydia trachomatis. Symptoms of chlamydia are similar to symptoms of gonorrhea, and the disease often occurs at the same time as gonorrhea. Men and women may have pain during urination or notice an unusual genital discharge one to three weeks after exposure. However, many individuals, particularly women, have no symptoms until complications develop.

Complications resulting from untreated chlamydia occur when the bacteria has a chance to travel in the body. Chlamydia can result in pelvic inflammatory disease in women, a condition which occurs when the infection travels up the uterus and fallopian tubes. This condition can lead to infertility. In men, the infection can lead to epididymitis, inflammation of the epididymis, a structure on the testes where spermatozoa are stored. This too can lead to infertility. Untreated chlamydia infection can cause eye infection or pneumonia in babies of mothers with the infection. Antibiotics are successful against chlamydia.

The progression of chancroid in the United States is a modern-day indicator of the migration of sexually transmitted disease. Chancroid, a bacterial infection caused by Haemophilus ducreyi, was common in Africa and rare in the United States until the 1980s. Beginning in the mid-1980s, there were outbreaks of chancroid in a number of large cities and migrant-labor communities in the United States. The number of chancroid cases increased dramatically, from 665 in 1984 to 4,714 in 1989.

In men, who are most likely to develop chancroid, the disease is characterized by painful open sores and swollen lymph nodes in the groin. The sores are generally softer than the harder chancre seen in syphilis. Women may also develop painful sores. They may feel pain urinating and may have bleeding or discharge in the rectal and vaginal areas. Chancroid can be treated effectively with antibiotics.