Why are more and more people contracting STDs and how do we stop it?

Cases of STDs have increased for a variety of reasons. How can one avoid getting infected, and what are the signs that infection has occurred?

 A couple in bed together, sex (Illustrative) (photo credit: Wikimedia Commons)
A couple in bed together, sex (Illustrative)
(photo credit: Wikimedia Commons)

The swinging 60's and 70's were characterized by free sex, and consequently also a high incidence of sexually transmitted infections. From then until now, we’ve come a long way regarding safe sex education, and today there’s a higher awareness that starts in elementary school with lessons on healthy sexuality along with the mass of unfiltered information on the web and what’s spread via social networks.

With the growth of sex ed and after the AIDS crisis there should have been a steady downward trend in the number of people infected with sexually transmitted diseases (STDs), but surprisingly in recent years the rate has increased — and some types of infections have seen double, even triple the number of cases in the last decade.

One main reason for the increase in STDs is society’s increasing openness towards discussing sex and acceptance of different sexual lifestyles. The more partners one has, the more likely one is to get infected and transmit those infections to another. The fear of AIDS has greatly diminished since effective drugs enable someone to have HIV which won’t develop into AIDS. Yet, this risk reduction has led to a decrease in condom use and an increase in exposure and risk of contracting various sexually transmitted diseases.

The term "sexually transmitted diseases" is a very general concept that includes a wide variety of diagnoses, which all have in common that the infection is caused by sexual contact. Many women mistakenly believe that they’re having safe sex, but aren’t aware that the great majority of sexually transmitted diseases (except perhaps HIV) can be transmitted even when using a condom because these infections are also transmitted through oral sex. 

Condoms reduce the risk of contracting sexually transmitted diseases but can’t give absolute protection. Common sexually transmitted diseases are chlamydia and gonorrhea which cause inflammation of the urethra in men, and the vagina and cervix in women. In women, when these infections aren’t treated one’s fertility will be affected. Other common infections are the papillomavirus i.e. HPV which causes warts on the genitals and cervical cancer, syphilis with its many complications including damage to the central nervous system and the risk of harm to a fetus when pregnant women are infected, and HIV which requires daily lifelong medication.

An empty condom wrapper lies on the street in Havana, Cuba, August 27, 2018. (credit: REUTERS)An empty condom wrapper lies on the street in Havana, Cuba, August 27, 2018. (credit: REUTERS)

Tips for safe sex and preventing infection are simple for those who give them, but not always easy to apply in the moment of truth. But it’s important that you know these tips. Also, if you’re infected, with all of these diseases early detection is very important which will allow you to receive the correct treatment and prevent further transmission to your partners.

Safe sex and using a condom are generally good advice. Talk about it with your partner. If you’ve started a new relationship, be sure to use a condom until both partners test negative for common infections.

Periodic testing. If you know your status and so does your partner, you can behave responsibly towards each other. We know that the absolute majority of people have a sense of responsibility towards their partners, and it’s important to them not to endanger anyone. The frequency with which you should be tested for the various infections depends on your level of exposure and you should discuss it with your family doctor or with a doctor at an STD clinic. If you change partners frequently, get tested every three to six months. And of course earlier if you have developed symptoms.

There are several infections that have vaccines you should request. Two prevent hepatitis B and HPV. Men who have sex with men should also be vaccinated against hepatitis A. Infection with the papillomavirus is almost universal since everyone is exposed to this virus after the first or second partner and the vaccine has been proven to reduce the risk of cancer and the appearance of genital warts.

 When do STDs become dangerous?

Many patients who have contracted an infection through sexual contact are surprised by the diagnosis. They say that their partner seemed "clean", a completely wrong concept. Sexually transmitted infections are common infections that anyone can acquire and have nothing to do with cleanliness or dirt. Also, some symptoms aren’t noticeable.

If you’ve developed signs of infections immediately contact a doctor to receive treatment. This will reduce the risk of complications and the transmission of the infection to your partners. It goes without saying that until diagnosis and effective treatment, you must abstain.

Which symptoms should turn on a warning light?

A wound or any new skin lesion in the genitals signals an infection. In men discharge from the penis, burning when urinating, pain, swelling, or redness in the testicles are signs.

In men who have sex with men bloody diarrhea, pain when defecating, or discharge from the anus can indicate chlamydia or gonorrhea infection, which is often misdiagnosed as inflammatory bowel disease.

Women should look for new or abnormal vaginal discharge, lesions or wounds, pain or bleeding following intercourse, and pain in the lower abdomen.

Dr. David Shasha is an expert in infectious diseases and the director of the STD clinic at Meuhedet.