Std(s) Health Dictionary

Sexually transmitted diseases – traditionally called venereal diseases – are infections transmitted by sexual intercourse (heterosexual and homosexual). In the United Kingdom they are treated in genito-urinary medicine (GUM) clinics. The incidences of these diseases are more common among people who have several sexual partners, as STDs are very infectious; some of the major STDs, particularly AIDS/HIV, are also transmitted by blood and so can result from needle-sharing by drug addicts, or by TRANSFUSION. The ‘traditional’ STDs – SYPHILIS, GONORRHOEA and CHANCROID – now comprise only 10 per cent of all such diseases treated in STD clinics: these clinics also treat patients with CHLAMYDIA, TRICHOMONIASIS, HERPES GENITALIS, MOLLUSCUM CONTAGIOSUM and genital WARTS. SCABIES and pubic lice (see PEDICULOSIS – Pediculus pubis) can also be transmitted by sexual intercourse, and HEPATITIS B is also recognised as an STD.

The incidence of STDs rose sharply during World War II but the advent of PENICILLIN and subsequent antibiotics meant that syphilis and gonorrhoea could be treated e?ectively. The arrival of oral contraception and more tolerant public attitudes to sexual activities resulted in an increase in the incidence of sexually transmitted infections. The diagnosis of NONSPECIFIC URETHRITIS (NSU), once given to many patients whose symptoms were not due to the traditional recognised infections, was in the 1970s realised to be wrong, as the condition was proved to be the result of infection by chlamydia.

Most STDs are treatable, but herpes is an infection that could become chronic, while hepatitis B and, of course, AIDS/HIV are potentially fatal – although treatment of HIV is now proving more e?ective. As well as the treatment and subsequent monitoring of patients with STDs, one of the important functions of clinics has been the tracing, treatment and follow-up of sexual contacts of infected individuals, a procedure that is conducted con?dentially.

Apart from AIDS/HIV, the incidence of STDs fell during the 1980s; however in some countries the agents causing syphilis and gonorrhoea began to develop resistance to antibiotics, which showed the continued importance of practising safe sex – in particular by restricting the number of sexual partners and ensuring the regular use of condoms. In the United Kingdom the rates per million of the male population infected by syphilis rose from 8.8 in 1991 to 9.7 in 1999; in females the ?gures were 4.0 to 4.5, respectively. For gonorrhoea, the ?gures for men were 399.4 in 1991 and 385 in 1999, with women also showing a reduction, from

216.5 to 171.3. In 1991, 552.6 per million of men had chlamydia, a ?gure which rose to

829.5 in 1999; for women in the same period the incidence also rose, from 622.5 to 1,077.1 per million. For genital herpes simplex virus, the infection rate for men fell from 236.6 per million to 227.7, whereas the ?gures for women showed a rise, 258.5 to 357. The incidence of AIDS/HIV is given under the relevant entry. (These ?gures are based on information in United Kingdom Health Statistics, 2001 edition, UKHSI, published by the O?ce of National Statistics.)... sexually transmitted diseases (stds)