Sexually Transmitted Diseases

In the US, an estimated 2 million cases of gonorrhea occur a year. There was 72.799 cases of syphilis in 1981, Chlamydia trachomatous is widespread, genital herpes affects 500,000 to 1 million people per year, and pelvic inflammatory disease (PID) afflicts more than 850,000 women annually, which makes it among the most frequent sexually transmitted diseases (STDs). The victims of hepatitis A and hepatitis B are usually homosexual men. Treatment is available for most of these diseases, although it can be expensive. Health promotion targeted at teenagers and cultural groups can be effective, since premarital sex rose from 30% of women aged 15-19 in 1971 to 50% by 1979. Counseling on STDs is vital, but moral and social prophylaxis has also brought results in China as it did during World War II in the US. The condom or other barrier methods failed to protect 9% of women among 52,000 STD clinic attenders during 1977 and 1980, while 21% of nonusers were infected with gonorrhea. Spermicides, antiseptics, and antibiotic solutions also proved effective against infections. Systemic prophylaxis including arsenicals, bismuth, sulfathiazole, benzathine penicillin G, oral doxycycline, and broad spectrum antibiotics have been used as treatment for syphilis and gonorrhea. IUDs have been implicated in PID. The hepatitis B vaccine proved potent, but the gonococcal vaccine failed. Vaccines for group B streptococcal infections, genital herpes, and cytomegalovirus (CMV) are under study. STDs can cause disease, disability, and death to the fetus, thus careful history taking and aggressive use of caesareans is advised in women with STDs. Screening contact tracing, and mass treatment can allow early detection and elimination of STDs. Infectious syphilis among prostitutes and farm workers decreased by 51.3 and 26.8%, respectively, in California in the early 1970s as a result of mass treatment. Vaccines and rapid diagnostic tests can bring STDs under control and eventually eliminate them.