STDs can be divided into two general categories, those that can be cured and those that currently cannot. Syphilis, chancroid, gonorrhea, chlamydial infection, and trichomoniasis [trik”o-mo-ní-ah-sis] are the most common curable STDs seen by FP/MCH providers. All are bacterial, except for trichomoniasis, which is a protozoan infection.
All incurable STDs are viral. The most dangerous viral STD is human immunodeficiency virus (HIV), which leads to AIDS. Other incurable viral STDs include human papilloma virus (HPV), hepatitis B and genital herpes. In this presentation, genital herpes will be referred to as herpes.
While viral STDs cannot currently be cured, treatment can relieve some of their symptoms and reduce the severity of some of their consequences.
Three viral STDs, HPV, herpes and HIV, are at epidemic proportions.
It is estimated that 30 million new infections of HPV and 20 million new cases of herpes occur every year.
The HIV/AIDS epidemic is of particular concern because AIDS is currently both incurable and eventually fatal. As of 1998, nearly 30 million adults and children were believed to be living with HIV/AIDS worldwide, according to the Joint United Nations Programme on HIV/AIDS (UNAIDS) and WHO. New infections occur at a rate of 16,000 every day, or about 6 million each year. In developing countries, about six of every 10 infected adults are men, but in much of the world the proportion of women with HIV infection is rising.
In 1998, more than two-thirds of adults and children with HIV lived in sub-Saharan Africa. The HIV/AIDS epidemic is also spreading rapidly in South and Southeast Asia and in Eastern Europe.
STDs can have severe medical consequences, including death.
Untreated gonorrhea and chlamydia can cause pelvic inflammatory disease, or PID, in women, which can lead to infertility or chronic pain. PID can also cause ectopic pregnancy with subsequent maternal death. Cervical cancer is closely associated with certain types of HPV infection. This cancer is common and has high mortality rates in many developing countries, where screening programs for its early detection are limited.
Some STDs, such as herpes and syphilis, may affect pregnancy outcome, causing spontaneous abortion, premature birth and stillbirth. Gonorrhea and chlamydia can also affect the babies born to infected women, causing eye infections and blindness. Syphilis, HIV and herpes can be transmitted to newborns, potentially causing chronic disease and death. In addition, herpes can lead to mental retardation in babies. Additional information could be found at the Viamedic Sexual Health Resource Center.