Importance of Preventing Sexually Transmitted Diseases

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Importance of Preventing Sexually Transmitted Diseases

Daniela Montalvo
Miami Regional University
ENC2201: Report Writing and Research Methods
Dr. Uliana Gancea
April 11, 2022

Abstract

While research shows that no one preventative measure can curb cases of HIV prevalence, high rates of infertility, and pelvic inflammatory diseases, STIs prevention has shown to be an effective way of drastically reducing these cases. This is because most STIs are the leading causes of these conditions. Therefore, reducing the rates of STIs is an essential aspect of reducing these cases worldwide. We shall look into the relationship between STIs and HIV prevalence, high infertility rates, and pelvic inflammatory diseases. Using a systematic review of previous research papers, we shall seek to show the importance of preventing STIs.

Keywords: preventing STIs, curbing HIV prevalence, infertility rates, pelvic inflammatory diseases, reproductive health.

Importance of Preventing Sexually Transmitted Diseases

An astounding 376 million sexually transmitted (STI) curable infections emerge annually across the globe. Sexual transmission accounts for more than 80% of all new HIV diagnoses (WHO, 2019). The immense strain of STI morbidity and death has a significant effect on the quality of life, sexual and reproductive health (SRH), and infant health, and as co-components for the transmission of HIV subsequently (Mayaud & McCormick, 2001). The risk of acquiring or transmitting HIV is significantly increased by sexually transmissible diseases like syphilis, chancroid ulcer, and genital herpes simplex virus ulcer. In some instances, they represent over 40% or more HIV transmissions (WHO, 2019).
In the evolution of sexually transmitted infection (STI) management, as with other infectious diseases, the pendulum moves around vertical disease-specific and broader horizontal interventions, from a focused emphasis on conditions and their care to people’s more extensive interests that harbor and spread them. STI prevention efforts have been more and more established with respect to the goals of HIV programs since the introduction of HIV in the 1980s. While HIV itself is an STI, attempts to deter its transmission are primarily controlled by funding, execution, and evaluation programs, regardless of other STI management efforts.
Such a broken model has a harmful effect. Too frequently, the overlooked STI programs – the basis on which attempts were made to avoid HIV – fail when funding is limited. As a result, STI hospitals and programs are under-personalized, overlooked, or entirely lost (Steen et al., 2009). HIV testing may be provided for pregnant mothers, but STIs such as syphilis are no longer being thoroughly checked. Furthermore, STI reporting, a vital indicator for sexually transmitted infection inclinations, has withered away. This paper seeks to evaluate the need for putting more emphasis on the prevention of sexually transmitted diseases.

Background Information

Sexually transmitted infections (STIs) are sexually propagated diseases. There is a universally known transmission of more than 30 different bacteria, viruses, and parasites via sexual intercourse (Mayaud & McCormick, 2001). The higher prevalence of sexually transmitted diseases lies in 8 of these viruses. 4 of these eight diseases are syphilis, gonorrhea, and chlamydia, and trichomoniasis is treatable. The remaining 4 are untreatable viral infections: hepatitis B, herpes simplex (HSV), HIV, and human papillomavirus (HPV). Medication may lessen or modify the complications or illness caused by untreatable infectious diseases. STIs are predominantly transmitted through sex, including vaginal, anal, and oral intercourse. Some STIs can also be transmitted by non-sexual methods, for example, by blood (Mayaud & McCormick, 2001).
Several STIs – including syphilis, hepatitis B, HIV, chlamydia, gonorrhea, herpes, and HPV – can also be spread from mother to infant during pregnancy and breastfeeding (CDC, 1998). Any person may have STI without apparent disease signs. STIs commonly involve vaginal release, urethral fluid or male burning, genital ulcers, and stomach discomfort (WHO, 2019). While in recent decades in the United States, the number of confirmed STIs has decreased slightly, the number of such infections is still very high in children and teenagers. Roughly 25% of teens can get STIs before high school graduation. About 376 million cases of STIs are recorded every year (WHO, 2019). Bacteria or viruses cause STIs. Anyone who has sex with someone else will have it.
While STI manifestations can range from moderate discomfort, soreness to the extreme pain, signs sometimes do not occur. For instance, a sexually transmitted infection known as chlamydia usually has no symptoms, or when they appear, they are just moderate. The diagnosis is often not made until there are problems. Young adults and teenagers are more likely to experience STIs than any other age group (WHO, 2019). One of the principal factors being that they often have sexual intercourse. They are much more likely to get infected genetically. Furthermore, health care facilities may be less used to provide them with knowledge about how to defend themselves from STIs (WHO, 2019).

Problem Statement

STIs are deeply affected globally by sexual and reproductive health. Per day, there are over 1 million recorded cases of STIs (WHO, 2019). In 2016, the World Health Organization reported 376 million new cases with 1 out of 4 STIs: chlamydia (127 million), gonorrhea (87 million), Syphilis (6.3 million), and Trichomoniasis (156 million). Over 300 million women have an HPV infection, which is believed to be the most significant cause of cervical cancer. More than 500 million are diagnosed with HPV (herpes) infection worldwide (WHO, 2019). In addition to the acute effect of the infection itself, STIs may have more significant effects.
For instance, the risk of HIV acquisition can be three times or more increased by STIs such as herpes or syphilis (Mayaud & McCormick, 2001). The transfer of STI from mother to infant will lead to mortality, neonatal death, reduced weight, premature delivery, sepsis, neonatal connectivity, pneumonia, and congenital abnormalities. Also, it has been estimated that over 1 million pregnant women had active syphilis in 2016 and that more than 350 000 adverse birth results, of which 200 000 were fatal or neonatal, were presented (WHO, 2019). HPV infection causes a total of 570 000 estimated incidence and over 300 000 deaths per year from cervical cancer. Pelvic inflammatory conditions (PID) and female infertility are mainly caused by STIs such as gonorrhea or chlamydia.

Research Question

The research was necessitated by the reduced emphasis on STI reduction programs since the inception of HIV. This has seen the number of STIs increase. With reduced screening, it is assumed that many more cases go unrecorded each year. With over 1 million cases recorded each day worldwide, there is a need to address this global problem. This research sought to answer the following questions.
1. Is there any relationship between STIs and HIV transmission? Does reducing STIs reduce HIV prevalence?
2. Does preventing STIs reduce the infertility rate? And
3. Does preventing STIs reduce the significant health issues brought by pelvic inflammatory diseases?

Hypothesis

Null Hypothesis

· Preventing STIs reduces the prevalence of HIV disease
· Preventing STIs reduces the infertility rate
· Preventing STIs reduces the complications from pelvic inflammatory diseases

Alternative Hypothesis

· There is no connection between STIs and the prevalence of HIV. Preventing STIs does not reduce the HIV prevalence rate.
· Preventing STIs does not reduce infertility rates.
· Preventing STIs does not reduce the complications of pelvic inflammatory diseases.

Thesis Statement

In order to curb the rising rates of HIV prevalence, infertility, and pelvic inflammatory diseases, there is a need to rethink the importance of preventing STIs, which are the major causes of these problems.

Review

Over time, prevention of STIs has taken place to HIV prevention. This is has led to reduced funding for STIs prevention. Notably, research has shown a direct link between STIs and the high risk of HIV infections (Mayaud & McCormick, 2001). There is also a link between STIs and infertility, as well as complications from pelvic inflammatory diseases. We reviewed several previous research articles to answer our research questions; whether preventing STIs directly impacts HIV prevalence; whether preventing STIs reduces infertility rates; and, whether preventing STIs reduces complications emanating from pelvic inflammatory diseases.
Kurth et al. (2010) note that no one prevention measure can lead to curbing HIV prevalence. However, research has shown that preventing STIs will significantly reduce HIV prevalence (Grosskurth et al., 2000, Steen et al., 2009). Steen et al. (2009) asserted that curbing STI prevalence reduces cofactors that reduce the effectiveness of HIV transmission. HIV epidemics have become increasingly susceptible to countries with inadequate STI regulation, although STI control changes have occurred simultaneous or proceeded a decrease in HIV incidence and prevalence (CDC, 1998, Grosskurth et al., 2000, Steen et al., 2009). Countries controlling STIs are more likely to stop and cure their HIV epidemics than governments preventing STIs. Significant HIV epidemics have developed and expanded quickly under inadequate STI regulation (Steen et al., 2009).
Consequently, further deteriorating STI reduction measures may well hinder additional attempts to prevent HIV (Grosskurth et al., 2000). According to CDC (1998), in 1997, ACHSP found evidence that the early diagnosis and treatment of other STDs is an important HIV infection prevention technique. The approach has not been well defined or enforced in the United States as a vital tool for preventing HIV. With STDs in many areas of the United States continuing to be high and evidence emerges of a growing U.S. HIV and AIDS outbreak, demographic populations with the highest incidence of curable STDs are rapidly affected (CDC, 1998). According to Brady (2003), there is a close interrelation between infertility and STIs.

Method

In this research, we used the systematic review research method. We used databases such as Springer, Science Direct, and PubMed to develop several articles that were used for the research. Some of the keywords used in the search were STI prevention, the relationship between STIs and HIV, infertility, and PIDs. Over 25 articles published for the last three decades were analyzed. However, we used only 7 of the articles plus the CDC’s information to come up with the results provided here. These articles are “Preventing Sexually Transmitted Infections and Unintended Pregnancy, and Safeguarding Fertility: Triple Protection Needs of Young Women” by Brady, M. (2003), “Control of sexually transmitted diseases for HIV-1 prevention: understanding the implications of the Mwanza and Rakai trials” by Grosskurth et al. (2000), “Combination HIV Prevention: Significance, Challenges, and Opportunities” by Kurth et al. (2010), “Importance of sexually transmitted infections in funding for HIV within proposals to the Global Fund” by Lusti-Narasimhan et al. (2011), “Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm” by Steen et al. (2009), “Global burden of maternal and congenital syphilis and associated adverse birth outcomes—Estimates for 2016 and progress since 2012” by Korenromp et al. (2019) and, “Interventions against sexually transmitted infections (STI) to prevent HIV infection” by Mayaud, & McCormick. (2001).

Results

Cases of HIV infections significantly reduce when the infection rates of STIs reduce. This is because most of these STIs, such as syphilis, chancroid ulcer, and genital herpes simplex virus ulcer, increase the probability of HIV transmission. Likewise, using preventative measures to curb sexually transmitted infections/diseases leads to reduced infertility rates and unintended pregnancies. There is a reduced number of conditions such as pre-natal deaths and other maternal-related problems due to STIs prevention such as syphilis.

Discussion

Methods of STI prevention include the use of condoms, avoiding the sharing of towels and undergarments, vaccination, and screening. Cases of HIV infections significantly reduce when the infection rates of STIs reduce. This is because most of these STIs, such as syphilis, chancroid ulcer, and genital herpes simplex virus ulcer, increase the probability of HIV transmission (Grosskurth et al., 2000, Kurth et al., 2010, Steen et al.,2009, Mayaud. & McCormick., 2001). Likewise, using preventative measures to curb sexually transmitted infections/diseases leads to a reduced number of infertility rates, as well as unintended pregnancies (Brady, 2003).
There is a reduced number of conditions such as pre-natal deaths and other maternal-related problems due to STIs prevention, such as syphilis (Korenromp et al.,2019). Given that prior research has shown the interrelationship between STIs and HIV, infertility, and PIDs, there is a need for more emphasis on STI prevention. As Kurth et al. (2010) note, there is a need to focus on multi-preventative measures to curb HIV prevalence.

Limitations and Implications

Some of the limitations of this research include lack of static data due to overlooking prevention of STIs, time constraints, ethical issues such as people not talking freely about their struggle with STIs, among others. This study implies a need for an emphasis on the prevention of STIs to achieve low HIV prevalence and few or no cases of infertility and conditions arising from pelvic inflammatory diseases.

Conclusion

An astounding 376 million sexually transmitted (STI) curable infections emerge annually across the globe. Sexual transmission accounts for more than 80% of all new HIV diagnoses. The immense strain of STI morbidity and death has a significant effect on the quality of life, sexual and reproductive health (SRH), and infant health, and as co-components for the transmission of HIV subsequently. The risk of acquiring or transmitting HIV is significantly increased by sexually transmissible diseases like syphilis, chancroid ulcer, and genital herpes simplex virus ulcers. Therefore, there is a need to emphasize curbing the transmission of STIs as it reduces HIV prevalence rate, infertility rates, and pelvic inflammatory diseases.

References
Brady, M. (2003). Preventing Sexually Transmitted Infections and Unintended Pregnancy, and Safeguarding Fertility: Triple Protection Needs of Young Women. Reproductive Health Matters, 11(22), 134–141. https://doi.org/10.1016/s0968-8080(03)02289-4
CDC. (1998, July 31). HIV Prevention Through Early Detection and Treatment of Other Sexually Transmitted Diseases — United States Recommendations of the Advisory Committee for HIV and STD Prevention. CDC.Gov. https://wonder.cdc.gov/wonder/PrevGuid/m0054174/m0054174.asp
Grosskurth, H., Gray, R., Hayes, R., Mabey, D., & Wawer, M. (2000). Control of sexually transmitted diseases for HIV-1 prevention: understanding the implications of the Mwanza and Rakai trials. The Lancet, 355(9219), 1981–1987. https://doi.org/10.1016/s0140-6736(00)02336-9
Korenromp, E. L., Rowley, J., Alonso, M., Mello, M. B., Wijesooriya, N. S., Mahiané, S. G., Ishikawa, N., Le, L. V., Newman-Owiredu, M., Nagelkerke, N., Newman, L., Kamb, M., Broutet, N., & Taylor, M. M. (2019). Global burden of maternal and congenital syphilis and associated adverse birth outcomes—Estimates for 2016 and progress since 2012. PLOS ONE, 14(2), e0211720. https://doi.org/10.1371/journal.pone.0211720
Kurth, A. E., Celum, C., Baeten, J. M., Vermund, S. H., & Wasserheit, J. N. (2010). Combination HIV Prevention: Significance, Challenges, and Opportunities. Current HIV/AIDS Reports, 8(1), 62–72. https://doi.org/10.1007/s11904-010-0063-3
Lusti-Narasimhan, M., Ndowa, F., & Pires, S. S. (2011). Importance of sexually transmitted infections in funding for HIV within proposals to the Global Fund. Sexually Transmitted Infections, 87(Suppl 2), ii19–ii22. https://doi.org/10.1136/sextrans-2011-050183
Mayaud, P., & McCormick, D. (2001). Interventions against sexually transmitted infections (STI) to prevent HIV infection. British Medical Bulletin, 58(1), 129–153. https://doi.org/10.1093/bmb/58.1.129
Steen, R., Elvira Wi, T., Kamali, A., & Ndowa, F. (2009). Control of sexually transmitted infections and prevention of HIV transmission: mending a fractured paradigm. Bulletin of the World Health Organization, 87(11), 858–865. https://doi.org/10.2471/blt.08.059212
WHO. (2019, June 14). Sexually transmitted infections (STIs). World Health Organization. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)