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Common STDs in South Australia

Glossary

STD information for students

Sexually Transmitted Diseases Defined

The term "venereal disease" or VD, was initially given to the diseases syphilis and gonorrhoea, which were once thought to be a single disease. The term "venereal" emphasises the part played by sex in the spread of diseases that would not otherwise be considered as a single group. Sexually transmitted disease (STD) is not the same as genital disease in fact, most genital diseases are not caused by sexually transmitted organisms. However, most sexually transmitted infections do involve the genitals. Infection of the rectum, throat, and conjunctiva of the eye are also common, but initial infection of other parts of the body is rare. Several sexually transmitted diseases spread from an initial site and produce sores in many parts of the body.

There is fairly consistent agreement that at least a dozen diseases are sexually transmitted. See Statistic Section for their relative frequencies in South Australia. In some countries lymphogranuloma venereum (LGV), chancroid, and donovanosis are also included in the legal definition of venereal disease, causing many people to seek treatment at STD clinics, but they are not regarded as STDs. Although the causative organisms can be passed on during sexual intercourse, they occur commonly in a large proportion of the population and the symptoms usually result from some illness or lowered resistance in the infected person.

In western society, sexually transmitted diseases occur mainly in people 15 to 30 years of age. However, some younger people are also affected and in some underdeveloped communities infection is common in older individuals. People with one sexually transmitted infection are usually at high risk for other diseases common in the same environment. In South Australia, many clients attending a clinic solely "for an AIDS test" are found to have one or two and sometimes even more STDs, even though their AIDS test is usually negative.

For many STDs, more male cases are reported than female cases. In some communities, a limited number of women (e.g. prostitutes) may have sex with a large number of men. Also, infection passed on by homosexual contact may increase the proportion of male infections. In many parts of the world (not Australia), 50 percent or more of reported syphilis infections result from homosexual contact.

The statistics on sex differences may not reflect the actual situation however, because infected women often show no symptoms and are more difficult to diagnose than men. The fact that many infected women show no symptoms of STDs is especially unfortunate since the complications can be quite serious in pregnant women. Infections such as syphilis, herpes, cytomegalovirus, and HIV infection may be passed on either to the foetus or during childbirth. The foetus or baby may suffer from the disease and in some cases die from it.

The management of STDs involves three parts: treatment, counselling, and follow-up. Standard types of treatment have been developed for most STDs. Wherever possible treatment is given in a single dose, but in some cases continues for a longer time. The doctor or health worker should always explain the disease, its treatment, and other aspects of its management to the client. A person may remain infected even if symptoms disappear, or may become reinfected immediately after treatment, so a follow-up visit is important. To avoid possible spread of infection the infected person should not have sex until the follow-up visit has confirmed the cure (usually from three to fourteen days after the end of treatment). The sex partners of clients with any venereal infection should also seek medical examination. This helps prevent further spread throughout the community and also reduces the chances of reinfection for the original client. "Ping-pong" infection —passing disease back and forth between two partners who are treated alternately—can be prevented if both partners seek treatment together.

Examples of Sexually Transmitted Diseases

STDs are infectious diseases spread from person-to-person through direct body contact or contact with infected body fluids. The term is used to describe any disease acquired primarily through sexual contact.

STDs are infections you can get through having oral, anal or vaginal sex with an infected partner. An individual can become infected with more than one STD at a time. It is unlikely that STDs can be transmitted from inanimate objects other than sex toys—an object has to have fresh and wet with contaminated body fluid on it (Crowe & Norsigian, 1984). So, despite the stories, toilet seats are a very unlikely source of infection!

The major groups of sexually transmitted organisms are:

• bacteria - responsible for gonorrhoea, including gonococcal pelvic inflammatory disease (PID), syphilis, bacterial vaginosis;
• mycoplasmas and chlamydiae (these are bacteria but they do not have rigid cell walls) - mycoplasmas are responsible for non-gonococcal urethritis (including chlamydial) and cervicitis. Chlamydia trachomatis is primarily responsible for chlamydial PID;
• viruses (the smallest known disease-causing agents) - important viral STDs include hepatitis B, and C, genital herpes, molluscum contagiosum, human papilloma virus (HPV-genital warts), and the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS);
• fungi (plant-like organisms) - causing candidiasis (thrush);
• protozoa (single-celled microscopic forms of animal life) - responsible for trichomoniasis;
• metazoa (all other animal life forms) - causing scabies and pediculosis pubis (pubic lice or "crabs").

The most common or serious STDs in South Australia are chlamydia, genital herpes, genital warts, gonorrhoea, HIV/AIDS, trichomoniasis, syphilis, pubic lice, scabies, hepatitis B and C, and non-specific urethritis (NSU).

Less common infections include chancroid and donovanosis.

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