Sexually transmitted diseases (STD)

Sexually transmitted diseases (STDs) are a major public health problem worldwide. According to the WHO, the annual incidence of such diseases is 357 million cases, half of which were detected to girls and young women aged 15 to 24 years. Every day, nearly 1 million women worldwide suffer from STDs, and most of them are unaware of their infectious status, making them a source of infection for others. STDs are often asymptomatic and can lead to various complications. The immediate goal of STD screening is to identify and treat infected individuals before complications develop, and to identify, test, and treat their sexual partners to prevent transmission and re-infection.

The group of sexually transmitted diseases includes:

syphilis, gonorrhea, trichomoniasis, chlamydia, mycoplasmosis, HIV, hepatitis B virus, HPV (human papilloma virus), HSV-2 (genital herpes simplex virus type 2). Diseases such as vaginal candidiasis and bacterial vaginosis caused by opportunistic pathogens are not currently sexually transmitted diseases, but are often considered in conjunction with them.

The main ways of STD transmission are:

• sexual, including vaginal, anal and oral sex;
• hemocontact, through blood transfusions or blood products;
• contact - transmission during long and close contacts: during kisses, close hugs, through common objects (shoes, towels, washcloths, combs, underwear, etc.), in a shared bath or sauna you shouldn’t sit / lie down on uncovered shelf;
• vertical, from mother to child during pregnancy and childbirth.

How to detect sexually transmitted diseases in time? The main thing is to see a doctor in time with the main symptoms, namely:

• vaginal discharge,
• discharge from the urethra,
• ulcers or warts on the genitals,
• pain in the lower abdomen,
• pain during sexual contact,
• feeling of sharp pains and heartburn during urination,
• itching and rash on the genitals.

It is also advisable to screen all STDs at the same time and it is recommended to examine all sexual partners of the patient. The main method to accurately differentiate the disease – the laboratory diagnostics:

• polymerase chain reaction (PCR) allows to detect in the sample of biological material (in the secretions of the urethra, cervical canal or vagina) fragments of DNA or RNA of the pathogen. PCR diagnostics is a highly sensitive method and allows to detect the pathogen even with low level in the sample;
• microscopy of urogenital secretions allows to detect the pathogen in a sample of biological material;
• microbiological study of urogenital secretions is the seeding of biological material on a nutrient medium in order to identify the causative agent of infection;
• rapid tests - rapid immunochromatographic qualitative tests to detect infection in a sample of material.

The treatment of sexually transmitted diseases is, firstly, the simultaneous treatment of both partners. Secondly, in the complex therapy, depending on the identified pathogen and the symptoms that bother the woman. And it is important to remember that the correct diagnostics and treatment are very important in prevention of serious complications, such as secondary infertility. For prophylactic purposes, it is necessary to be vaccinated against hepatitis B and human papillomaviruses, as well as to use male and female condoms correctly and systematically, and to pass the periodic examinations for sexually transmitted infections.

Sources:

• Khalil G Ghanem, Susan Tuddenham. Screening for sexually transmitted infections. UpToDate. Oct 28, 2021.
• Shvelidze M. Коляденко К. Обізнаність та знання про хороби, що передаються статевим шляхом, серед населення Грузії (епідеміологічне дослідження). УЖДВК № 4, 2021.
• Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recomm Rep 2021; 70:1.
• www.amnu.gov.ua (веб-сайт Національної академії медичних наук України).