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The popular rock group Bon Jovi has a song titled "Love
is a Social Disease". This title is not far from the truth. While
love is certainly social, love itself w ll not give one a disease. On
the other hand sex, as associated wth love, may expose one to
many social diseases. These social diseases are properly
termed sexually transmitted diseases (STDs). While casual
social contact such as a party or date has no possibility of trans
mitting an STD, nowadays the casual social contact is often a
prelude to casual sex.
"Despite what the media hipsters say," writes Samuel
S. Montefiore in a Psychology Today article ("Love, Lies & Fear
in the Plague Years"; Sept/Oct 1992), "Montefiore believes
casual sex is alive and well among the twentysomething set."
Casual sex or promiscuity is increasingly portrayed in
the movies as glamorous and desirable - an example of this is
Madonna in Truth or Dare. Unfortunately, movies almost never
show the real consequences of promiscuity and casual sex.
"From the classic venereal diseases of gonorrhea and
syphilis the number of sexually transmitted disease agents has
grown to over 20 during the past two decades," say Richard L.
Sweet and Ronald Gibbs in Infectious Diseases of the Female
Genital Tract. Therefore, it is imperative that every sexually
active person be aware of the modes of transmission and
consequences of STDs, say Sweet and Gibbs, and especially
important, howto protect oneself from them.
The traditional diseases were curable with antimicrobial
therapy, but the newer STDs are associated wth larger, incur
able conditions. Emphasis has been placed by the Center for
Disease Control (CDC) on chlamydia, herpes simplex virus
(HSV), human papilloma virus (HPV), hepatitis B (HBV), and to
the fatal disease AIDS caused by the human immunodeficiency
virus (HIV).
This redirection does not reflect the emergence of new
pathogens (disease producing agents), with the exception of
AIDS. These diseases are more apparent now because of
improved laboratory diagnostic techniques that helped investi
gators discover the true extent, transmission and consequences
of STDs. The age of sexually active adults has lowered and as a
result the incidences of chlamydia, HSV and HPV have risen.
Also some infections that are spread by different modes are now
being transmitted sexually; these include hepatitis B virus (HBV)
and cytomegalo (CMV).
'With the exception of AIDS, STDs are now associated
with more serious longterm consequences in wsmen than in
men," Sweet and Gibbs wrote in Infectious Diseases. 'These
SANDRA SHAP (NYC DEPT. OF HEALTH), "YOU CAN'T LIVE ON HOPE"
BY CLAIRE E. TRAMMELL
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complications include: 1) an increased risk for genital cancer
with HPV; 2) loss of reproductive capability because of damage
to the fallopian tubes wth chlamydia; 3) complications of preg
nancy, including prematurity; 4) transmission of serious fatal
infections to the fetus or newborn, such as syphilis, gonorrhea,
HSV, chlamydia, CMV, or HBV."
There are more than 20 STDs. The most common
among them are syphilis, gonorrhea, chlamydia, HPV, HBV and
HSV. Knowledge of the causes and manifestations are impera
tive to their prevention and possible cure, though some are
currently incurable. Among the STDs that are curable are
syphilis, gononhea and chlamydia.
SYPHILIS
As described in Infectious Diseases of the Female
Genital Tract, syphilis is a chronic infectious process due to the
a spirochete Trepenema pallidum.
Syphilis is an STD that is acquired through skin contact
with a chancre (the primary lesion) which appears at the site
where the spirochete entered the body (usually the genital area)
three to four weeks after contact. Syphilis can be detected by a
blood test. If untreated, the chancre disappears in three to six
weeks.
In second stage syphilis a generalized body rash may
appear which may last from two to six weeks. After the rash
disappears, the patient enters the latent stage in which no
symptoms are apparent. The patient may still transmit the
disease for up to one year after contracting syphilis. If left
untreated for over one year syphilis may cause progressive
damage to the central nervous system, musculoskeletal system
or cardiovascular system.
"It is estimated that about 120,000 new cases of primary
and secondary syphilis occur annually in the United States,"
Sweet and Gibbs wrote in Infectious Diseases. Tests to detect
syphilis rely on direct smears wth the chancre and blood tests to
determine the presence of antibodies.
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Anyone who has had a sexual partner diagnosed with
syphilis should be treated and penicillin is the drug of choice.
For those allergic to penicillin other drugs are available. The
doses of penicillin are usually low and maintained for periods of
one-tvwo weeks.
Other than the first two stages, syphilis has no symp
toms and for a fetus syphilis may mean death. For these
reasons pregnant women are screened for syphilis at their first
prenatal care appointment. If syphilis is found and eradicated
before the fourth month of pregnancy, a healthy birth is possible.
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GONORRHEA
"Historical records indicate that gonorrhea is the oldest
STD and its symptoms were documented in the Old Testament,"
Sweet and Gibbs wrote. According to Infectious Diseases of the
Female Genital Tract, "Gononhea is caused by a bacteria and
the law requires doctors to report any cases of gonorrhea to
public health officials, therefore gonorrhea is the most common
ly reported STD. Because gonorrhea is not always reported the
estimated number of new cases a year is approximately two
million."
The symptoms of infection are painful urination and a
puslike discharge. In males the symptoms are usually apparent,
but in females the infection may be "asymptomatic" (having no
symptoms). When a woman does show symptoms, she may
also have abnormal bleeding and pelvic discomfort. Gonorrhea
is detected usually by a cervical culture for women and a similar
sample obtained from the male penis.
Gonorrhea is usually treated with a single dose of
ampicillin, penicillin, or amoxicillin. For pregnant women erythro
mycin is recommended. If the disease is not eradicated before
birth and the baby is delivered vaginally the infection will affect
the eyes. The eyes will be treated with the normal drops used at
birth and then irrigated hourly until the discharge is eliminated.
nitrate be put in each newbom’S eyes to prevent any STD
infection.
Males are more likely to infect females simply because
males have fewer mucousal membrane openings in the genital
area. But females may also infect males, which is a good reason
anyone with an STD of any type should inform all of their sexual
partners. Fortunately for men, the infections are usually sympto
matic, but if the infection is left untreated may cause urethritis
(infection of the urethra).
Diagnosis of chlamydia infection is done w th a culture
test of the cervix, or for men a urine sample w ll suffice. The
usual treatment for chlamydia is tetracycline or erythromycin for
seven days.
Syphilis, gonorrhea and chlamydia are all curable, but
there are STDs which are incurable and these include genital
human papillmovirus (HPV), hepatitis B (HBV) and herpes
(HSV).
GENITAL HUMAN PAPILLMOVIRUS
Human papilloma virus (HPV) is an STD and causes
genital warts. These may appear as cauliflower-like warts on the
genitals. The appearance may vary because there have now
been over 60 types of genital warts identified. HPV is spread
through skin to skin contact wth an infected person while the
virus is being shed. Genital warts are highly contagious and
experts say that if AIDS were not around, genital warts would be
the story of the decade.
'The disease is so infectious that two-thirds of sex
partners of persons wth genital warts develop the disease, wth
an average incubation period of two to three months," Janet
Hyde wrote in Understanding Human Sexuality. As stated in
Infectious Diseases of the Female Genital Tract, 'Young, sex
ually active adolescents and adults are the highest prevalence
group for genital warts and the lesions occur in the urogenital
CHLAMYDIA
According to Infectious Diseases of the Female Genital
Tract, "Chlamydia is the most common STD in the United States
and it is estimated to cause over four million new cases of
infection each year." Chlamydia is caused by a bacteria called
chlamydia trachomatis and is considered to be the leading
cause of preventable blindness in the world.
Symptoms of chlamydia infection are painful urination
and puslike discharge. These are the same symptoms as
gonorrhea infection and the two are often partners in a double
infection. This is unfortunate because the gonorrhea may be
treated wthout the possibility of chlamydia being considered.
The chlamydia infection usually goes unnoticed because
it is frequently asymptomatic (for women) and can pass unde
tected into the upper genital tract and cause serious complica
tions. For women these may include pelvic inflammatory
disease, infertility and pregnancy complications.
The most commonly infected site wthin the female is
the cervix and this may make the female body more susceptible
to pelvic inflammatory disease (inflammation of the tissue of the
uterus or fallopian tubes). Inflammation of the fallopian tubes is
called salpingitis, and infertility may result if the scar tissue from
infection blocks the fallopian tubes.
Pregnant women may also infect their infants during
birth. A baby bom to an infected mother may develop an eye
infection, which is why most states require that drops of silver
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