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SEXUALLY TRANSMITTED INFECTION |
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| Introduction |
| Looking
Beyond 'THE CAUSE' |
| Treatment |
| Differential
Susceptibility |
| STIs
And Adolescence |
| Impact
of STIs on Individuals and Community |
| Links |
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| Introduction
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| Sexually Transmitted Infections,
as the name indicates are infections predominantly transmitted
through the sexual route. They are also referred to as Sexually
Transmitted Diseases (STIs). |
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| A list of common STIs is given below.
(Source American Social Health Association) |
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| http://www.ashaSTD.org/STDfaqs/index.html |
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| AIDS and HIV |
Human immunodeficiency
virus or HIV is a virus that attacks the immune system resulting
in Acquired Immunodeficiency Syndrome, or AIDS. |
Chancroid
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A treatable bacterial infection
that causes painful sores. |
| Chlamydia
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A treatable bacterial infection
that can scar the fallopian tubes affecting a woman's ability
to have children. |
| Crabs |
Also known as pediculosis pubis,
crabs are parasites or bugs that live on the pubic hair in the
genital area. |
| Gonorrhoea |
A treatable bacterial infection
of the penis, vagina or anus that causes pain, or burning feeling
as well as a pus-like discharge. Also known as "the clap".
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| Hepatitis |
A disease that affects the liver.
There are more than four types. A and B are the most common.
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| Herpes |
Genital herpes is a recurrent skin
condition that can cause skin irritations in the genital region
(anus, vagina, penis). |
| Human
Papillomavirus/Genital Warts |
Human papillomavirus (HPV) is a
virus that affects the skin in the genital area, as well as
a female's cervix. Depending on the type of HPV involved, symptoms
can be in the form of wart-like growths, or abnormal cell changes.
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| Molluscum Contagiosum |
Molluscum Contagiosum is a skin
disease that is caused by a virus, usually causing lesions or
bumps. |
| Nongonococcal Urethritis (NGU) |
Nongonococcal urethritis (or NGU)
is a treatable bacterial infection of the urethra (the tube
within the penis) often times associated with chlamydia. |
| Pelvic Inflammatory Disease |
An infection of the female reproductive
organs by chlamydia, gonorrhoea or other bacteria. Also known
as PID. |
| Scabies |
Scabies is a treatable skin disease
that is caused by a parasite. |
| Syphilis |
A treatable bacterial infection
that can spread throughout the body and affect the heart, brain,
nerves. Also known as "syph". |
| Vaginitis |
Caused by different germs including
yeast and trichomoniasis, vaginitis is an infection of the vagina
resulting in itching, burning, vaginal discharge and an odd
odour. |
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| STIs
- Looking Beyond 'THE CAUSE' |
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| Infective organisms cause STIs. These
organisms may be virus, bacteria or other agents. |
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| But it is important to look beyond
these direct causes and understand the dynamics of STI causation.
Insights into the dynamics of STI causation provide logic and
direction to efforts in STI prevention and treatment. |
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- STIs are predominantly a disease linked to poverty. STIs
are seen more among the poor than the affluent
- Lack of information on STIs and how they can be prevented
puts people at higher risk for STIs
- Cultural and subcultural norms that initiate and sustain
multi-partner sex increase the rate of STI infection
- Gender constructs that handicap women in negotiating sexual
behaviour increases chances of STIs
- Developing countries tend to have more STIs than developed
countries
- Stigma associated with sex and STIs is a major hindrance
to prevention efforts and early treatment. -
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| Thus, to understand STIs, it is important
to look at them from these different perspectives. Social, economic,
cultural and other factors pave the way for the infective organism
to enter the human body. Treatment of the infection would cure
a single episode of STI, but simultaneously addressing other
determinants of STIs empowers the community to lessen the chances
of getting infected. |
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| Treatment
of STIs in a clinical setting |
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| Treatment of STIs in a clinical setting
aims not only to cure the patient of the current infection but
also to empower the patient to prevent further infections. Thus
good quality STI treatment goes beyond mere diagnosis and prescriptions.
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| Quality STI care should include the
following minimum features - |
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- Physicians and other health care providers who have a
non-judgemental attitudes to clients with STIs
- Adequate privacy for consultation and clinical examination
- Facility for STI counselling that provides accurate information
on STIs, education on condom usage and provision of condoms
and promotion of partner notification
- Facility for basic laboratory investigations
- Effective prescription practices suited to the need of
the client -
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| Control of STIs in
community context |
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| Clinical management of STIs alone
cannot achieve control over STIs. Control of STIs in community
context requires approaches that use different paradigms. The
core elements of a community approach or public health approach
to STIs would include the following· |
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- Epidemiological studies to assess the baseline STI figures
and patterns of distribution
- Surveillance to track the STI figures and patterns of
distribution
- STI education to public that promotes health care seeking
and safer sex behaviours
- Improving the quality of STI care and access to care
- Developing and managing specific interventions for groups
with special needs
- Allocation of adequate financial resources and building
up sufficient technical capacities for STI programmes -
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| Differential
Susceptibility to STIs |
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| There is a clear differential susceptibility
in the way STIs infect men and women - - |
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- All groups of people are potentially at risk for STIs,
but women, teens, and minorities have greater risk.
- Complications of STIs are more severe and more frequent
among women than men.
- Infected women are more susceptible to reproductive cancers
and infertility
- STIs are less likely to produce symptoms in women, and
therefore are less likely to be diagnosed until serious
problems develop.
- Women are biologically more susceptible than men to becoming
infected if exposed to an STI. For example, a woman's risk
of contracting gonorrhoea from one act of unprotected intercourse
may be as high as 90%, while the risk to a man is about
20-30%.
- The risk of contracting HIV from one act of intercourse
has been estimated to be eight times higher from man to
woman as it is from woman to man. -
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| STIs
and Adolescence |
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- A high percentage of STIs occur during adolescence
- Adolescents are at high risk for acquiring an STI because
they are more likely to have multiple partners and they
may be more likely to have unprotected intercourse.
- Compared to older adult women, female adolescents are
also more susceptible to cervical infections, such as gonorrhoea
and chlamydia, due to their immature cervix.
- Chlamydia is more common among adolescents than among
adult men and women; in some studies, up to 30-40% of sexually
active teenage women were infected with chlamydia. -
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| Impact
of STIs on Individuals and Community |
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| The actual prevalence of STIs and
suffering related to STI is grossly underestimated because of
the silence that surrounds STIs. The stigma associated with
the disease effectively screens out public visibility to the
issue in contrast to other diseases like diabetes or hypertension.
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| STIs can cause a wide spectrum of
effects on an individual ranging from complete absence of symptoms
to life-threatening complications. On individuals it can also
cause significant psychological impact. |
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- Although many STIs are curable, some are not, and all
can lead to serious and enduring health consequences.
- People with an active syphilis, genital herpes, chancroid
infection or who have chlamydia, gonorrhoea, or trichomoniasis
are 3 to 5 times more likely to contract HIV if exposed
than other people.
- Millions of women, men and children are affected by long-term
complications of STIs, including a variety of cancers, infertility,
ectopic pregnancy and miscarriage, and other chronic diseases.
- A significant portion of women is infertile because of
tubal damage caused by pelvic inflammatory disease (PID),
resulting from an untreated STI.
- HIV epidemic has already caused range of impacts on a
scale that has no parallel in history. -
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| Links
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| Introduction |
(Source American Social Health Association).For
Details. |
| Treatment of STIs in a clinical setting |
CDC guidelines on treatment of STIs.
For Details. |
| Control of STIs in community context |
Sexually Transmitted Infections – WHO .For
Details. |
| Differential susceptibility to STIs |
Patriarchy and the Risks of STD and HIV Transmission
to Women.
For Details.
HIV/AIDS and women. For
Details. |
| Impact of STIs on individuals and community
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Issues in Brief: Sexually Transmitted Diseases
Hamper Development Efforts. For
Details. |
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