Prevention of sexually transmitted diseases (STDs) composes the main aspect of protection of sexual and reproductive health. Many of more than 30 bacterial, virus, and parasitic sexually transmitted pathogens, including HIV, are transferred mainly during sexual contacts. Some are also transferred from a mother to a child during pregnancy, childbirth, and breastfeeding. The WHO reports that annually in the world more than 340 million men and women aged 15 – 49 are for the first time infected with widespread bacterial and protozoan sexually transmitted infections like syphilis, gonorrhea, chlamydial sexually transmitted infections, and trichomoniasis (WHO, 2013). The given essay will discuss the basic aspects of STDs, current data and statistics, health disparities, prevention strategies, as well as recent researches of the disease.
Basic Aspects of STDs
Diseases transmitted sexually include all infectious diseases transferred by sex and contacts “from blood to blood” as any sexual contact is accompanied with micro traumas with capillary bleeding. The homosexual contacts are much more dangerous than the heterosexual ones as genitals are injured more than during heterosexual contacts. The modern medicine includes all infectious diseases transmitted from one person to another one during a sexual contact into the group of STDs. AIDS, both Hepatitis (B and C), trichomoniasis, ureaplasmosis, mycoplasmosis, papilloma virus, a contagious mollusk, and other rarer sexually transmitted infections belong to this group. (Edelman, Kudzma, & Mandle, 2014, p. 74).
An individual can have STDs even without evident symptoms. General symptoms of STDs are schmegma, voidings from the urethral channel in men, genital ulcers, and pains in a stomach. The greatest incidence is connected with 8 out of more than 30 known pathogens transferred during sexual contacts. At present, four of these eight infections, namely syphilis, gonorrhea, clamidiosis, and trichomoniasis are curable. The other four infections, which are hepatitis B, herpes, and AIDS/HIV, are virus incurable infections; however, their influence can be decreased owning to the correctly chosen therapy (CDC, 2015).
There are a number of diagnostics methods of STDs. The polymerase chain reaction (PCR) is the most accurate diagnostic method of STDs. This method allows defining the existence of the STD activator even if there are several molecules of the DNA of a microorganism in test. The PCR analysis allows diagnosing the existence of long growing activators without resorting to the microbiological methods, which are topical at the diagnosis of urogenital infections and STDs (Healthy People 2020, 2015).
STDs do not obligatory have symptoms or can have soft and passing symptoms. However, they can cause severe complications such as infertility, extra-uterine pregnancy, chronic diseases, and even premature death. Chlamydial infections, gonorrhea, and syphilis can cause severe and often menacing consequences to the fetus development and life of newborn children, including congenital diseases, pneumonia, and low weight at the birth. The infectioning with papilloma virus increases the probability of the development of the cervical cancer, which is the second leading cause of death in women among all oncological diseases. Annually, more than 240,000 women die of STDs around the world (Healthy People 2020, 2015).
Current Data and Statistics
The recent statistics on bacterial and virus STDs does not show a true picture of incidence. Modern urbanization, distribution of nuclear materials, and acid rains destroy the immune system cells. STD and skin specialists claim that clamidiosis, bacterial vaginoses, and many other diseases have become a scourge of the 21st century. (Edelman, Kudzma, & Mandle, 2014, p. 83). STDs make a deep impact on reproductive and sexual health across the world and enter the top five main categories of diseases in connection with which adult population asks for a medical care. Daily, more than 1 million people are infected with STDs. Annually, 500 million people get one of four STDs: clamidiosis, syphilis, trichomoniasis, and gonorrhea (CDC, 2015; Healthy People 2020, 2015).
According to the WHO’s estimations, the number of new cases of four curable sexually transmitted infections among people aged 15 – 49 remain steadily high: Chlamydia trachomatis (146 million); Neisseria gonorrhoeae (51 million); syphilis (5 million); and Trichomonas vaginalis (239 million). Besides, the prevalence indicators of some virus STDs are high: 417 million people are infected with type 2 simple herpes and about 291 million women with a papilloma virus. More than 530 million people have hepatitis. More than 290 million women have HIV infection, which is one of the most widespread STDs (WHO, 2013). (Fig. 1).
STDs can have severe consequences except for a direct impact of the infection. Some STDs can thrice increase the risk of the HIV acquisition. In more than 305,000 cases, STDs during pregnancy lead to a fetus or newborn deaths. The HIV-positive indicator in women results in more than 530,000 cervical cancer cases and 275,000 cases of death from it. Such STDs as gonorrhea and clamidiosis compose the main reasons for the inflammatory diseases of a small pelvis body, miscarriages, and infertility (Workowski, Bolan, & CCD 2015).
STD is one of the most widespread diseases in the world. Even developed countries overtake the third-world countries in some incidence indicators. The STDs incidence is so much higher in African and Asian countries of Africa that they have become the epidemic. The risk groups include those who neither want nor can be cured. At present, risk groups of STDs, especially of Chlamydia trachomatis, are composed of various people. Young people having a diverse sexual life belong to them. Besides, STDs are often met among marginalized population groups like commercial sex workers, men having homosexual relations, prisoners, etc. (Workowski, Bolan, & CCD, 2015).
Practically all people of any age having a regular sexual life belong to a risk group of genital herpes and a papilloma virus. The age of 25 connected with the peak of human sexual activity is the peak of STDs. The risk group includes women having inflammatory genitals diseases, especially of a recurring nature. Moreover, high rates of STDs are noted among people older than 50. They use condoms six times less often and are five times less often checked for AIDS than the younger generation though the risk of infectioning is approximately identical (Workowski, Bolan, & CCD, 2015).
Speaking of races and nationalities, the African Americans belong to the most vulnerable group of people with STDs. These vulnerable groups of people are more subject to the development of STDs than the whites. The indicators of STDs remain high among the Afro-Americans even after sexual behavior corrections and probably reflect a high prevalence of STDs among sexual partners in the Afro-American community all over the world. Other behavioral risk factors connected with positive reactions on STDs include a number of sexual partners during life and young age at the beginning of sexual life. Among social factors of STDs spread, there is poverty, low social status, unemployment, low intelligence level, etc. (Healthy People 2020, 2015). The Center for Disease Control and Prevention (2014) states:
Research shows that there are higher rates of STDs among some racial or ethnic minority groups compared to whites. It is important to understand that these higher rates are not caused by color or heritage, but by social conditions that are more likely to affect minorities. Factors such as poverty, large gaps between the rich and the poor, few jobs, and low education levels can make it more difficult for people to stay sexually healthy. (CDC, 2014)
Thus, different risk groups among population correspond to the development of different STDs. Both developed and developing countries are characterized by a big diversity of the STDs’ spread. However, racial and ethnic minorities are more vulnerable to STDs if compared to the whites due to behavioral and social factors.
The WHO’s global strategy for 2016-2021 aimed at the prevention of STDs is based on achievements and experience of the done work and is coordinated with other global and regional strategies and plans in the field of health care (WHO, 2013). There are four strategic activities:
- High quality services and interventions. Each country should define a complex of main measures of intervention and services concerning STDs prevention. Priority should be given to highly effective measures covering all aspects of prevention, diagnostics, treatment, and health care provision to patients with STDs. Moreover, complex packages provide a bigger influence than separate measures of intervention. The interventions aimed at the decrease of the STDs spread include the decrease of risk and vulnerability, especially among key population groups, STDs prevention, early STDs diagnostics, treatment of the patients with STDs, coverage of sexual partners, rendition of health care services, and others;
- Ensuring compliance with the principle of justice and achievement of influence. Free access to effective services of the STDs treatment should be fair and free from discrimination or negligence. It is also necessary to pay special attention to geographical areas with the highest rates of incidence and transmission of infection to cover key population groups with appropriate prevention and treatment services and to orient at definite situations;
- Innovations for acceleration. The achievement of target indicators of the strategy will demand the application of a new framework of existing technologies and methods. All possible barriers and obstacles can be overcome by means of carefully developed operational researches and innovations. The optimization of prevention, diagnostic, treatment, and rendering of health care services can give positive results in combating the STDs;
- Financing for ensuring sustainability of the measures against STDs. It demands actions in such areas as mobilization of sufficient volume of financial means for financing of programs preventing STDs; creation of fair mechanisms of the unification of the protective means against financial risks; and optimization of the use of resources by decrease in expenses and increase of efficiency (WHO, 2013).
Recent Researches of STDs
Due to the increasing incidence of STDs all over the world, new researches have been launched. Some of them are aimed at the increase of awareness about sexual behavior as well as the impact of drug abuse on the vulnerability to STDs among the youth. The other group of trials is focused on the prevention of STDs among the teens with mental disorders and pregnant women. However, the majority of researches aim at the increase of reproductive education and contraceptive awareness (CDC, 2015).
Despite considerable efforts made to define simple measures capable to reduce the scale of risky sexual behavior, the change of behavior remains a complex challenge. Recent scientific researches have revealed the need for the orientation at carefully established groups of the population, extensive consultation with the established target population groups, and their attraction to the development, implementation, and assessment of the scales of the problem of STDs, etc. (CDC, 2015; Healthy People 2020, 2015).
The STDs rates increase almost in all parts of the globe. It is caused by a number of behavioral and social factors. Recent achievements and innovations of the medical science allow curing STDs effectively. The WHO and the CDC recommend implementing an early diagnostics and prevention of STDs by means of the increase in awareness of the population, especially among key risky groups. Moreover, geographical areas with high incidence rates should be under a special control of the world states. Sustainable innovations and financing are also included into the prevention strategies applied by the WHO all over the world.