SEXUALLY TRANSMITTED INFECTIONS (STIs):

Introduction:

STIs are very common

These include gonorrhoea (most common), syphilis, chlamydia, trichomonas, chancroid etc.

There are over 330 million new curable STIs

About 1 million infections occur every day

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

A major public health problem both in developed and developing countries

Higher in developing countries because treatment is less accessible

Syphilis prevalence rates are higher in women 10 to 100 times

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Vulnerable Groups:

Sexually active teenage girls

Women with several sex partners

Commercial sex workers and their clients

Men and women whose jobs force them to be away from their families or regular sex partners for long
periods of time

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Mode of Transmission:

Unprotected sex

Mother to child – during pregnancy (HIV, syphilis), at delivery (gonorrhoea, chlamydia) or after birth
(HIV)

Transfusion or other contact with blood or blood products eg. Syphilis, HIV

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Behaviours that Influence Transmission:

A recent change of a partner

Having more than one partner

Having a partner who have more other partners

Having sex with casual partners, commercial sex workers or other clients

Continuing to have sex with symptoms of STI

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Social Factors Influencing Transmission of STIs:

Failure to follow safe sex measures eg.

Condom use

2. Delay in getting STIs treatment

People not taking the full prescribed course of treatment for STIs

Failure to bring sexual partners for treatment including stigma

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Biological Factors that Influence Transmission of STIs:

Age – the nature of the vaginal mucosa puts young women at high risk if they become sexually active in
early teenage years

Gender- STIs are primarily transmitted to

women through intercourse

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

- Easier for women to be infected

because of their large exposed

surface area

Circumcision – circumcised men are less likely to get STI than uncircumcised men
SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Who is Affected:

STIs including HIV/AIDS are widespread through out the world

They affect sexually active people of both sexes

Most children under 14 years are free from STIs other than congenital infections eg. Syphilis, opthalmia
neonatarum and HIV

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Between ages 14 and 19 STIs occur commonly in female because;

They usually start sex early

They have sex with older partners who are more experienced and more likely to carry infection

Biological vulnerability of young girls/ large surface area

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

For both males and females STIs tend to be higher between 15 – 30 years of age

Studies show that after 19 years STIs occur more in males because;

STIs produce no symptoms or only mild in women, so fewer women come forward for treatment

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Services in general are more accessible in men than women

Cultural and economical constraints

Large number of men might be infected after practicing unsafe sex with a smaller number of sex workers

Older men are more sexually active than women of the same age

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Men are more likely to change sex partners than women

Studies have shown that sub-Saharan Africa, behavior of the male partner places women at risk of STI
acquisition

Data shows that women who were married to less educated men were at an increased risk of STIs

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Poor education leads to unemployment & subsequently poverty

Individuals with low income have been shown to have a high prevalence of STIs

This could be due to high risk sexual behavior exhibited by poorly educated men

Men have been shown to be more likely to engage in concurrent sexual relationships than women 

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Common Symptoms of STIs:

Vaginal or urethral discharge e.g. gonorrhea

Vaginal itching

Pain on urination

Pain during sexual relations

Frequent urination

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Genital ulcers e.g. Chancroid, syphylis, herpes. Genital warts

Lower abdominal pain e.g. PID

Scrotal swelling

Painful enlarged inguinal lymph nodes e.g. Lymphogranuloma

Swollen eyes which may be discharging

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Challenges of controlling STIs:

It is difficult to change sexual behavior

Sex is embarrassing to discuss

Many STIs carriers have no symptoms

Treatment is not always simple or effective

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Control of STIs:

Early effective therapy

Education and communication on

Dangers of high risk behaviors

Need of compliance with treatment drugs

Condom promotion on proper use

Adopting a positive attitude

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Treatment of sexual partners

Target vulnerable groups

Complications of STIs:

In women:

Chronic abdominal pain or infertility

Death due to infection, ectopic pregnancy, cancer of the cervix

Abortion

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

Domestic violence, divorce when husband learns that the wife has STI

Blindness and pneumonia in infants

SEXUALLY TRANSMITTED INFECTIONS (STIs): Cont

In men:

Urethral stricture

Infertility

Heart disease

Domestic violence, divorce when the wife learns that the husband has STI