Sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) are serious public health concern that affects millions of people worldwide. The prevalence of STIs and STDs is on the rise and has become a silent epidemic that is spreading faster than ever. This has serious consequences for both individuals and society at large.

 What are STDs?

STIs are infections that are spread through sexual contact, including vaginal, anal, or oral sex. They can be caused by bacteria, viruses, or parasites, and they can have serious health consequences if left untreated. Some of the most common STIs include chlamydia, gonorrhea, herpes, human papillomavirus (HPV), and syphilis. Discussing STIs and STDs is essential for raising awareness, reducing stigma, and preventing the spread of infections. Many people feel ashamed or embarrassed about discussing sexual health, leading to a lack of information, misconceptions, and risky behavior.

In my opinion, these things are what is making STIs a secret epidemic.

Why STDs Are Spreading Faster Than Ever

The truth is, the prevalence of STDs keeps increasing each year, however, in recent years, it has been faster than ever. The graph below shows the rate of increase in gonorrhea by gender from 2011 to 2020:

Image by CDC.GOV

From the graph it can be seen that the rate of increase in gonorrhea from the year 2011 to 2014 is approximately constant at a rate of 100, however, starts to increase dramatically from 2014 to 2020. Currently, it’s even higher. So, what could be causing the rapid spread? 

Here are some potential factors:

Changes in sexual behavior:

There have been several changes in sexual behavior that have contributed to the spread of STDs. Firstly, there has been an increase in sexual partners, particularly among younger age groups. This can increase the likelihood of coming into contact with an infected individual. 

Secondly, there has been a change in attitudes towards casual sex, with many people engaging in sexual activity with multiple partners without using protection.

Lastly, there has been a decrease in the use of condoms, which can greatly reduce the risk of contracting an STI.

Lack of sexual education:

There is a lack of comprehensive sexual education in many schools and communities. This means that many people are not equipped with the knowledge they need to protect themselves from STDs. Additionally, cultural barriers can prevent discussions around sex, particularly in more conservative communities, like Ghana. This can lead to a lack of access to accurate information, which can contribute to risky sexual behavior.

 Cost of screening and testing:

Limited access to testing is a major barrier to reducing the spread of STDs. This can be due to a lack of testing facilities in certain areas, as well as the cost of testing. Additionally, there is a stigma surrounding STI testing, which can prevent individuals from getting tested even if they are at risk. 

Finally, inadequate follow-up care can also contribute to the spread of STDs. Even if an individual test positive for an STI, they may not receive the treatment they need, leading to ongoing infection and transmission.

Common STDs and Their Prevalence

Chlamydia

 Chlamydia is a bacterial infection that is spread through sexual contact. It is one of the most common STIs and can cause serious health problems if left untreated. In many cases, chlamydia does not cause any symptoms, making it difficult to detect. According to the Centers for Disease Control and Prevention (CDC), there were over 1,579,885 cases of chlamydia reported in the United States in 2020.

 Gonorrhea

 Gonorrhea is another bacterial infection that is spread through sexual contact. Like chlamydia, it can cause serious health problems if left untreated. Gonorrhea can cause symptoms such as painful urination and discharge, but many people may not experience any symptoms at all. 

Herpes

Herpes is a viral infection that is spread through skin-to-skin contact during sexual activity. There are two types of herpes viruses: HSV-1, which typically causes cold sores in the mouth, and HSV-2, which is usually associated with genital herpes. Both types can be transmitted through sexual contact. Herpes can cause painful sores and blisters, but many people may not experience any symptoms.

HPV

Human papillomavirus (HPV) is a viral infection that is spread through skin-to-skin contact during sexual activity. There are many different types of HPV, some of which can cause genital warts or lead to cancer of the cervix, anus, or throat. Many people who are infected with HPV do not experience any symptoms, which can make it difficult to detect. According to the CDC, approximately 79 million Americans are currently infected with HPV, and about 14 million people become newly infected each year.

Syphilis

Syphilis is a bacterial infection that is spread through sexual contact. It can cause serious health problems if left untreated, including damage to the brain, nerves, and other organs. Syphilis can cause symptoms such as sores or rashes, but many people may not experience any symptoms at all. 

Consequences of Untreated STIs

For the consequences of untreated STDs, I will group them into two: short-term and long-term.

 Short-term consequences:

• Pain and discomfort:

Untreated STIs can cause a range of painful and uncomfortable symptoms, including itching, burning, and discharge.

For example, untreated gonorrhea can cause painful urination and discharge, while untreated chlamydia can cause pelvic pain and discharge.

• Infertility:

Untreated STIs can also lead to infertility. Chlamydia and gonorrhea can cause scarring of the fallopian tubes in women, which can lead to infertility. In men, untreated gonorrhea can lead to epididymitis, which can also cause infertility.

• Increased risk of HIV transmission:

Untreated STIs can increase the risk of HIV transmission. This is because STIs can cause inflammation and sores, which can provide a pathway for HIV to enter the body. 

 Long-term consequences:

• Chronic pain and discomfort:

Some untreated STDs can cause chronic pain and discomfort. For example, untreated chlamydia can lead to chronic pelvic pain in women, while untreated gonorrhea can lead to chronic pain and inflammation of the prostate gland in men.

• Increased risk of certain cancers:

Untreated HPV can lead to the development of certain cancers, including cervical, anal, and throat cancers. In fact, HPV is responsible for almost all cases of cervical cancer.

• Neurological damage:

Untreated syphilis can cause neurological damage, including dementia, blindness, and paralysis. This is because syphilis can progress to a late stage that can affect the brain and nervous system.

Prevention and Treatment of STDs

Preventative measures:

These measures are just preventive ways to help you reduce your chances of contracting an STI, and not guaranteed ways completely prevent it. The only guaranteed way of completely preventing STIs is ABSTAINANCE.

• Condom use:

Consistent and correct use of condoms during sexual activity can significantly reduce the risk of STI transmission. Condoms act as a barrier, preventing direct contact between bodily fluids and reducing the risk of transmission.

• Regular testing:

Regular testing is an essential part of preventing the spread of STDs. Individuals who are sexually active should get tested for STIs regularly, especially if they have multiple sexual partners or engage in unprotected sex.

• Vaccinations:

Vaccinations can also help prevent some STIs. For example, the HPV vaccine can prevent certain types of HPV that cause cervical cancer and genital warts. 

 The hepatitis B vaccine can prevent the transmission of hepatitis B, which can be spread through sexual contact.

Treatment options

• Antibiotics:

Many STIs can be treated with antibiotics. Antibiotics work by killing or stopping the growth of bacteria. Examples of STIs that can be treated with antibiotics include chlamydia, gonorrhea, and syphilis.

• Antiviral medication:

Some STIs, such as herpes and HIV, cannot be cured with antibiotics but can be managed with antiviral medications. Antiviral medications work by reducing the ability of the virus to replicate, and they can help reduce the frequency and severity of outbreaks.

• Supportive care:

In addition to medications, supportive care can also help manage STI symptoms. For example, over-the-counter pain relievers can help alleviate the pain associated with some STDs. Counseling and support groups can also help individuals cope with the emotional and social effects of living with an STI.

 Overall, prevention and early detection are key in the fight against STIs. 

Reducing the Spread of STIs

While the rates of STIs continue to rise, there are steps that can be taken to reduce their spread.

Increase in sexual education:

One of the most important steps in reducing the spread of STDs is to increase sexual education. As discussed earlier, the lack of comprehensive sexual education in schools has contributed to the spread of STIs. By educating individuals about safe sex practices and STI prevention, we can help reduce the rates of STIs.

 More accessible testing:

Increasing the accessibility of STI testing can also help reduce the spread of STDs. Many individuals may not get tested due to a lack of access to testing centers or the stigma surrounding STI testing. To address this issue, some health organizations have started offering at-home testing kits, making it easier for individuals to get tested in the privacy of their own homes. This can help remove some of the barriers to testing and encourage more people to get tested.

Reducing the stigma surrounding STIs:

The stigma surrounding STIs can make it difficult for individuals to seek testing and treatment. By reducing this stigma, we can help create a more supportive environment for individuals living with STIs. For instance, Jack, a young man living with HIV, used to feel ashamed and isolated due to the stigma surrounding his condition. However, after joining a support group and connecting with other people living with HIV, he found a community that accepted and supported him. 

 This helped him feel more empowered to manage his condition and reduce the risk of transmitting it to others.

 Encouraging the use of preventative measures:

Finally, encouraging the use of preventative measures, such as condoms and vaccinations, can help reduce the spread of STIs. This can be done through education campaigns, outreach programs, and partnerships with healthcare providers.

 For example, a community health clinic could offer free condoms and encourage individuals to use them during sexual activity. They could also offer information about the HPV vaccine and encourage eligible individuals to get vaccinated.

By taking these steps to reduce the spread of STDs, we can work towards a future where STIs are no longer a silent epidemic.