June 13, 2022 Author : Saraiva da Cunha Sexually transmitted infections are currently known as venereal diseases . These are infectious diseases caused by bacteria, viruses, fungi and parasites, whose contagion is mainly through sexual contact ; All are transmitted through sexual contact: vaginal, anal or oral; Some can also be transmitted through contact with body fluids, from infected blood and tissues if used in transfusions and transplants, and from mother to child during pregnancy and childbirth. Sexually transmitted infections can have serious consequences for long-term health and quality of life , notably because some can increase the risk of: Gynecological cancer; Infertility; Abortion, premature birth and problems in newborns; Cirrhosis and liver cancer; Human immunodeficiency virus (HIV) infection; Premature death. Among factors contributing to resurgence of sexually transmitted infections in recent decades are mainly behavioral issues: Earlier start of sexual activity; Lowest fear of an unwanted pregnancy; Frequent switch of sexual partners. Most important sexually transmitted infections More than 30 bacteria, fungi, viruses and parasites are currently known to be transmitted mainly through sexual contact. The main sexually transmitted infections are: Anogenital condylomas, caused by the human papilloma virus (HPV) ; Acquired immunodeficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV) ; Genital chlamydiosis , caused by the bacterium Chlamydia trachomatis ; Gonorrhea , caused by the bacterium Neisseria gonorrhoeae ; Genital herpes , caused by the Herpes simplex virus type 2; Genital mycoplasmosis , caused by the bacterium Mycoplasma genitalium ; Syphilis , caused by the bacterium Treponema pallidum ; Hepatitis B, caused by the hepatitis B virus (HBV); Trichomoniasis , caused by the parasite Trichomonas vaginalis . There are other infections that can also be transmitted by sexual contact, but this is not very important in the spread of the disease. Therefore, they are not considered sexually transmitted infections. This is the case, for example, with hepatitis A and C and the Zika virus. What signs and symptoms one should be aware Many sexually transmitted infections have no symptoms or symptoms are only mild . Some genital changes may be a sign that a sexually transmitted infection. Itching (pruritus), presence of ulcers or other genital lesions, genital burning sensation, abnormal vaginal discharge or discharge from the urethra, are always indications that medical attention should be sought; Medical observation and some tests, if necessary, will allow confirming or ruling out an STI and determining the appropriate treatment. How are STIs treated? The treatment of sexually transmitted infections depends on the infection . It may involve medication, but also other procedures, as is the case, for example, with genital warts. The goal of treatment also depends on the disease : it can be to cure it or prevent its worsening or long-term consequences. Chlamydiosis, vaginal candidiasis, gonorrhea, mycoplasmosis, syphilis and trichomoniasis, which are caused by bacteria, fungi and parasites, are curable ; Hepatitis B virus, Herpes simplex virus, human immunodeficiency virus (HIV) and human papilloma virus (HPV) infections do not have a curative treatment. The goal of treatment is to control the infection and its long-term effects . How to prevent sexually transmitted infections Measures that help reduce the likelihood of having a sexually transmitted infection are: Always use condoms (male and female condoms) in sexual relations; Avoid sexual intercourse , even when protected, when there is a possibility or suspicion or a sexually transmitted infection is already known; Vaccination . Some sexually transmitted infections are prevented by vaccination, such as human papilloma virus (HPV) and hepatitis B virus infections. The Portuguese national vaccination program currently includes vaccination against HPV, both for girls (since 2008) and boys (since 2020). People who have not been vaccinated under the national immunization program should talk with their attending physician about the need for this vaccine. There are medicines that reduce the chance of being infected with the human immunodeficiency virus (so-called pre-exposure prophylaxis or PrEP). Medical recommendation is, in Portugal, regulated by the Direção Geral da Saúde and depends on individual assessment in specialized consultations. Screening for sexually transmitted infections Maintaining regular medical follow-up (usually in general and family medicine, gynecology or urology, depending on the person) and carrying out the recommended screenings is essential to early diagnose and treat STIs and avoid contagion . Most STI screening is done using a blood or urine test. Some screenings that doctors may order are: In all people: Human immunodeficiency virus infection at least once in a lifetime Women under the age of 25 who are sexually active: Gonorrhea and chlamydiosis, annually Women over 25 years of age with more than one sexual partner and with sexual contacts not protected by a condom: Gonorrhea, chlamydiosis, human immunodeficiency virus and syphilis annually Pregnant women: Human immunodeficiency virus, syphilis and hepatitis B Chlamydiosis and gonorrhea if they are under 25 or if they have had more than one partner Men who have sex with men and with sexual contacts not protected by a condom: Gonorrhea, chlamydiosis, human immunodeficiency virus and syphilis annually. Hepatitis A, B and C, at least once People infected with the human immunodeficiency virus: Hepatitis A, B and C, at least once. Syphilis, chlamydiosis and gonorrhea, annually. Men who have sex with men who are infected with the human immunodeficiency virus: Hepatitis C annually Specific cases: Screenings dependent on sexual habits Some numbers In the world Every day there are more than 1 million of sexually transmitted infections; In 2016 there were 490 million people infected with the Herpes simplex virus and 300 million women with HPV; In 2020 there were 374 million new cases of chlamydiosis, gonorrhea, syphilis and trichomoniasis; It is estimated that 296 million people have chronic hepatitis B. In Europe and Portugal In 2018, in Europe about half a million STIs were registered, including: 100 526 cases of gonorrhea 33 599 cases of syphilis 40 6406 cases of chlamydiosis In 2018, in Portugal: 908 cases of syphilis , with a higher incidence in men aged 15-44 years; 479 cases of chlamydiosis , mainly in women and men aged 15-34 years; 789 cases of gonorrhea , with a higher incidence in men aged 15-34 years; In 2019, there were 778 new cases of HIV/AIDS in Portugal. Sources European Centre for Disease Prevention and Control. Infographic: Sexually transmitted infections: a long-standing and ongoing threat for public health , 10 Mars 2021. Serviço Nacional de Saúde: Doenças de Declaração Obrigatória . Uptodate. Screening for sexually transmitted infections . World Health Organization. Sexually transmitted infections Meet the infectious diseases clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
