Sexually transmitted diseases (STDs) are caused by a broad range of pathogens.
The syndromes caused by these pathogens affect both the sexually active couple and neonates born to an infected mother.
Bacterial STDs such as gonorrhea, syphilis, chancroid, donovanosis, and lymphogranuloma venereum can easily be cured with antimocrobial therapy. In contrast, viral STDs, such as those caused by human immunodeficiency virus (HIV), human papilloma virus (HPV), and herpes simplex virus 2(HSV-2), are chronic, incurable infections, characterized by prolonged viral shedding and opportunity for infecting a sexual partner; these cannot be cured by antiviral therapy. Nearly all sexually active individuals are at risk for these viral STDs, HPV persists in the ano genital mucosa for months, years, or decades after primary infection. HSV-2 infection is chronic and lifelong. Prevention offers the best approach to managing STDs.
Many STDs can be transmitted perinatally to the neonate. In developing nations, where STDs are more common, lack of funds for health care often limit detection and treatment of STDs as well as immunizations. Syphilis can be a lifelong infection with server long-term morbility. Transmission of HIV to neonates occurs commonly in developing nations, where the prevalence of infection is high. Zidovudine treatment of mother and neonate markedly reduces neonatal infection. Transmission of HSV has more immediate effects on the neonate can result in ano genital condyloma, and later in life, respiratory papillomatosis.
All individuals being evaluated for STDs should have a culture for gonorrhea and serology for syphilis. HIV testing is strongly advised. Serologic testing for HPV infections is not available. Type-specific serologic tests (TSST) for HSV infection, such as the western blot, are very reliable, detecting previous infection with HSV-1, HSV-2,or both.
The most effective way to prevent sexual transmission of STDs is to avoid sexual intercourse with an infected partner. Both new partners should get tested for STDs before initiating sexual intercourse. If a person chooses to have sexual intercourse with a partner whose infection status is unknown or who is infected with HIV or another STD, a new condom should be used for each actor of intercourse. Vaccines for STDs are limited at this time. Immunization for hepatitis A and hepatitis B is advised to prevent transmission of these viral infections during intercourse. Now, we have a vaccine for Human Papilloma Virus.