Sexually Transmitted Diseases/Sexually Transmitted Infections-Myths and Realities.

Recently, I received a mail from one Julia of Florida,age 40 years,asking me some queries regarding Pelvic Inflammatory disease(a kind of a syndrome related to STI).I was surprised  about the nature of questions which were asked,showed the extent of sheer ignorance and myths which may be prevailing in a civilized world like US,prompted me to leave other  posts and concentrate on the much burning and important topic-STD.or better known these days as Sexually Transmitted Infections(STI) or Venereal Disease ,over the next few weeks I will try to write as many possible myths and  realities about different infections .Curiously I tried to search about STI’s on different health and medical sites but most of them seem to have out dated material loaded or techniques which are not used these days.It is invariably not possible for me to write about each and every venereal infection separately but with best of my knowledge and resources available to me I have tried to compile about the most common myths.
STIs’ can be broadly classified into three types,which again are divided into three types,Bacterial,Viral and Others(Fungi,protozoan)

    • Infections primarily through sexual route.
    • Infections but not predominantly through other  routes,but sexual is a possible route.                                              
    • Infections through Oro-fecal  route,In gay communities.                                                                                           
      • SYNDROME
      • AIDS
      • Urethritis: males:-
            • Epididymitis
      • Lower genital tract infections: females:-
            • Cystitis/urethritis
            • Mucopurulent cervicitis
            • Vulvitis
            • Vulvovaginitis
            • Bacterial vaginosis (BV)
            • Acute pelvic inflammatory disease
            • Ulcerative lesions of the genitalia
            • Complications of pregnancy/puerperium
            • Proctitis
            • Proctocolitis or enterocolitis
            • Enteritis
            • Acute arthritis with urogenital
            • infection or viremia
            • Genital and anal warts
            • Mononucleosis syndrome
      • Infertility
      • Intestinal infections
      • Hepatitis
      • Neoplasias
      • Squamous cell dysplasias and
        cancers of the cervix, anus, vulva,
        vagina, or penis
      • Kaposi’s sarcoma, body-cavity
        lymphomas
      • T-cell leukemia
      • Hepatocellular carcinoma
      • Tropical spastic paraparesis
      • Scabies
      • Pubic lice
      • I’ve compiled this list to make people understand that what all names are STIs’.
      • With inputs from Harrison’s Medicine.

Here I will write about  most common myths pertaining practically to all STIs’ but before doing so pals ,answer the following very nice effective questionnaire,every one should ask oneself.
TEN-QUESTION STD/HIV RISK ASSESSMENTFraming Statement:
In order to provide the best care for you today and to
understand your risk for certain infections, it is necessary
for us to talk about your sexual behavior.
Screening Questions:
(1) Do you have any reason to think you might have a
sexually transmitted disease? If so, what reason?
(2) For all adolescents <18 years old: Have you begun
having any kind of sex yet?
STD History:
(3) Have you ever had any sexually transmitted diseases
or any genital infections? If so, which ones?
Sexual Preference:
(4) Have you had sex with men, women, or both?
Injection Drug Use:
(5) Have you ever injected yourself (“shot up”) with
drugs? (If yes, have you ever shared needles or
injection equipment?)
(6) Have you ever had sex with a gay or bisexual man or
with anyone who had ever injected drugs?
Characteristics of Partner(s):
(7) Has your sex partner(s) had any sexually transmitted
infections? If so, which ones?
STD Symptoms Checklist:
(8) Have you recently developed any of these symptoms?
For Men For Women
(a) Discharge of pus (a) Abnormal vaginal discharge
(drip) from the penis (increased amount,
(b) Genital sores (ulcers) abnormal odor, abnormal
or rash yellow color)
(b) Genital sores (ulcers),
rash, or itching
Sexual Practices, Past 2 Months (for patients answering
yes to any of the above questions, to guide examination
and testing):
(9) Now I’d like to ask what parts of your body may have
been sexually exposed to an STD (e.g., your penis,
mouth, vagina, anus)?
Query About Interest in STD Screening Tests (for
patients answering no to all of the above questions):
(10) Would you like to be tested for HIV or any
other STDs today? (If yes, clinician can explore
which STD and why.)
Source: Adapted from JR Curtis, KK Holmes, in KK Holmes et al (eds):
Sexually Transmitted Diseases, 3d ed. New York, McGraw-Hill, 1999.

Myths and Realities.

    1. I will not get infected with occasional change of partner.
      • A myth,sleeping with changed partner even once can infect you even though he /she appears to be a healthy lad,in my clinical experience generally people are reluctant even before medical professionals to accept about STI’s leave aside discussing with partners or many a times people aren’t aware that they are infected due to lack of symptoms,if infection is in early stage .While few infections like HIV have incubation period which may even last for years ,making one just a carrier and  infect others.
    2. I will not get infected with use of condoms.
      • True to some extent that it is the best possible barrier available today but if used with a infected person regularly can give infection in event of a mal function,leakage of bodily fluids,rupture,etc.
    3. I am already infected with one STI so I won’t be infected with other type.
      • This is one of biggest myths about STIs’,as written above STIs’ can be viral ,bacterial ,fungal,etc. meaning different kind of micro organisms are involved,so therefore an individual can suffer from two even three-four STIs’ at the same time.
    4. I am pregnant so won’t get any STI .
      • This is one of the myth, I don’t understand that even highly educated women around believe,beautiful mothers !!!this is a complete non sense,rather any STI can create  havoc to mother as well as fetus, adding to it, many medicine used to treat STI may have a cascading effect on  fetus which may even surface after few years of child birth.
    5. HIV cannot be cured so do other STIs’.
      • Yes HIV cannot be fully cured,but with proper treatment and care can be controlled to give patient a prolonged life span.
      • Regarding other STIs’ bacterial ones can be fully cured if diagnosed early and treated properly,few viral STI’s even have vaccines while other respond to anti-retroviral therapy.
    6. I will not get infected by using oral or anal route.
      • No,any minor injuries or cut on skin will make micro organisms to penetrate into oral cavity or anus or genitals.
      • Few STI’s like Herpes can spread just by  rubbing or skin to skin contact or kissing with the infected person.
    7. Contraceptive pills provide some protection against STIs’.
      • A complete myth,these pills are effective in controlling pregnancies,they have no roll whatsoever regarding STIs’,Condom is the best effective measure against STI.
    8. Circumcision means no STIs’.
      • A myth again ,this notion prevailed so strongly for years especially in African community that even people in Western world circumcised,but lot of studies over the years have proved this absolutely wrong.
      • In fact ,many researches have proved that circumcision should be done when medically justified,otherwise it is like giving yourself pain and agony with no use at all.
      • Please note I am not against religions/ethnic groups practicing circumcision but what ever I have mentioned is quoted from best researches available till date.

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