STDs - Sexually Transmitted Diseases

Venereal diseases are those pathologies that can be transmitted during sexual activities of various kinds. For this reason they are also known as STDs, an acronym for Sexually Transmitted Diseases. This category also includes pathologies which - although usually acquired in different ways (parenteral, orofecal, etc.) - can be transmitted sporadically or occasionally even through sexual contacts.

Index Article

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Around the middle of the last century, in the most industrialized countries, the improved socio-economic conditions and the therapeutic achievements after the war have considerably reduced the incidence of classic venereal diseases (syphilis, gonorrhea, etc.), to the point of suggesting their own gradual disappearance in the years to come. Subsequently, however, the group of sexually transmitted diseases gradually took shape and enriched itself with pathologies with different characteristics from those known until then. On the one hand, in developing countries there was to the spread of the most feared venereal disease, AIDS, while on the other, in the most industrialized nations, sexual promiscuity and globalization have helped to keep attention paid to this problem, which - far from being resolved - continues to absorb huge financial resources for public health every year.

Infectious Agents

Currently, the STD group recognizes over 30 different etiological agents, including viruses, bacteria, fungi and parasites. Among these, only some microorganisms are transmitted mainly by sexual contact:

Neisseria gonorrhea: bacterium responsible for gonorrhea (also called discharge or blenorrhagia);
Treponema pallidum: bacterium responsible for syphilis;
Chlamydia trachomatis: bacterium responsible for urethritis, cervicitis and pelvic inflammatory disease;
Trichomonas vaginalis: flagellate protozoan (unicellular organism) responsible for trichomoniasis;
HPV (Human PapillomaVirus): some types (16, 18, 31, 33, 45, 52 and 58) can cause cervical cancer, while other strains are responsible for acute warts;
HSV (Herpes Simplex Virus): some types (the one and in particular the two) are responsible for genital herpes.

Infection

Contagion occurs during sexual intercourse of various kinds (genital, oro-penile, oro-vaginal, anal) with direct contact with infected fluids, such as sperm, vaginal secretions and blood lost from small lesions. Anal coitus is particularly risky, often responsible for modest lacerations which become gates for germs. As regards petting, there is a certain risk of transmission in case of contact with the genitals or ejaculation in proximity to them.

Some microorganisms responsible for specific venereal diseases are instead transmitted with a certain frequency both sexually and parenterally; this is the case, for example, of AIDS and the hepatitis B virus, both common in some categories of drug addicts. In addition to the exchange of syringes, these venereal diseases can also be transmitted through the mixed use of razors or poorly sterilized cutting objects (for example for surgery or tattoos).

Other microorganisms recognize predominantly non-sexual modes of contagion; this is the case, for example, of the hepatitis A virus, Shigella, Campylobacter and Salmonella bacteria, as well as the parasites Giardia lamblia and Cryptosporidium, all transmitted mainly by fecal gold (ingestion of contaminated food), but also during sexual intercourse of oral-anal and genito-anal nature (including the sharing of sex toys that are not properly sterilized or protected by a condom). Cytomegalovirus and "Epstein barr virus can be transmitted either through sexual contact or through a simple kiss (saliva is a of infection).

In general, therefore, the etiological agents responsible for venereal diseases recognize different modes of transmission which, albeit rarely, may also include the mixed use of infected underwear, towels or toilet articles. Out of very few exceptions (we have seen the mononucleosis for kissing), venereal diseases are not transmitted by kissing another person, much less by drinking from the same glass or by shaking his hand; the use of public health systems is generally considered a low-risk practice, as most of the microorganisms responsible for venereal diseases do not survive for long outside the body.