Sexually transmitted disease

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Classification according to ICD-10
A50-A64 Infections that are mainly transmitted through sexual intercourse
ICD-10 online (WHO version 2019)

Sexually transmitted diseases , in German and English STD (sexually transmitted diseases) or STI (sexually transmitted infections) called, are those diseases caused by sexual intercourse can be transmitted. They can be caused by viruses , bacteria , fungi , protozoa, and parasitic arthropods .

The "venereal disease" was often synonymous with syphilis

STDs or Venereal Diseases ( English VD (venereal diseases) , formerly venereal ailments ) in the strict sense or Venerea (word origin see Venereology ) are transmitted only through sexual intercourse. They exist in humans and animals. In animals they are called veterinary cover diseases . For sexually transmitted diseases there is or was a legal obligation for the treating physicians to report to the competent authority (in Germany the health office or veterinary office ). In human medicine , only the occurrence of the illness is reported, but not the name of the sick person, because the patient file is always subject to data protection .

An early mention that infection with disease is possible through sexual intercourse was made in the 12th century by the English Benedictine Adelard von Bath .

The "classical sexually transmitted diseases" ( syphilis , gonorrhea , ulcus molle and lymphogranuloma venereum ), which had only been noticed to a greater extent in Europe since the end of the 15th century , were of little importance until recently, as they had become rare.

Much more significant - and sometimes much more difficult to treat - are currently: HIV infection and the immune deficiency acquired as a result, AIDS , hepatitis B , genital herpes , infections with chlamydia and trichomonads infections with Trichomonas vaginalis , pubic lice infestation , and infection with certain (so-called "High risk") Human papillomaviruses (HP viruses, HPV), some of which can cause cervical cancer . Today in Germany around 100,000 women are involuntarily childless as a result of untreated chlamydia-related infections, and more people die from hepatitis B than from other sexually transmitted diseases put together - a fact that is evident today with the vaccination against hepatitis B in infants and babies. Childhood is countered. Since 2006 there has also been a vaccination against the "high-risk" HP virus , which it is hoped will significantly reduce the incidence of cervical cancer.

Germany's medical association for the field of sexually transmitted diseases is the German STI Society (DSTIG) , which was founded in 1902 under the title German Society for Combating Venereal Diseases (DGBG).

Overview

Sexually Transmitted Disease: Pathogen:
Viruses:
HIV infection (can lead to full-blown AIDS ) HIV-1 and HIV-2
Condylomata acuminata ( genital warts , virus warts of the mucous membrane) and Buschke-Löwenstein tumor HPV types 6 and 11 ("low risk")
Condylomata plana (referred to as CIN, VIN, VAIN, AIN and PIN depending on the location) HPV types 6 and 11 ("low risk") as well as 16, 18 and 31 ("high risk")
Cervical intraepithelial neoplasia (CIN): can lead to cervical cancer ( cervical cancer ) HPV types 16, 18 and 31 ("high risk")
Bowenoid papulosis , mostly as in men intraepithelial neoplasia Penile (PIN, viral warts of the penis ) can Erythroplasia and penis cancer cause HPV , almost exclusively type 16 ("high risk")
Vulvar intraepithelial neoplasia (VIN, viral warts of the vulva ) HPV types 16, 18 and 31 ("high risk")
Vaginal intraepithelial neoplasia (VAIN, viral warts of the vaginal mucosa ) HPV types 16, 18 and 31 ("high risk")
Anal intraepithelial neoplasia (AIN, viral warts of the anus ) HPV types 16, 18 and 31 ("high risk")
Heck's disease (virus warts of the oral mucosa ) HPV types 13 and 32 ("low risk")
Molluscum contagiosum (dellular wart) MCV
Hepatitis A (from oro - anal contact) HAV
Hepatitis B ( hepatitis D ) HBV ( HDV )
Hepatitis C. HCV
Genital herpes HSV
Cytomegaly CMV
Bacteria:
Syphilis ( Lues venerea ) Treponema pallidum
Gonorrhea ( gonorrhea ) Neisseria gonorrhoeae
Ulcus molle (soft chancre) Haemophilus ducreyi
Granuloma inguinale Klebsiella granulomatis (formerly Donovania granulomatis )
Lymphogranuloma venereum Chlamydia trachomatis , serotypes L1 to L3
Ascending oculogenital chlamydial infection Chlamydia trachomatis , serotypes D to K
Urogenital mycoplasma infection see: Ureaplasma urealyticum genital mycoplasma
Bacterial vaginosis aerobic bacteria
Diarrhea (from oro - anal contact) Intestinal bacteria: Shigella , Salmonella , Campylobacter species
Mushrooms:
Candidiasis (candidiasis) Candida albicans
Protozoa:
Trichomoniasis Trichomonas vaginalis
Diarrhea (from oro - anal contact) Protozoa of the intestine: Giardia lamblia , Entamoeba histolytica , Cryptosporidium species
Arthropods:
Pubic louse infestation (pubic louse infestation, pediculosis pubis ) Pubic louse ( pubic louse , Phthirus pubis )
Scabies (Scabies) Scabies mite (Sarcoptes scabiei)
Partly from:

Reporting requirement

Experts |

The branch of medicine that deals with classic sexually transmitted diseases is venereology .

The specialist in charge of most sexually transmitted diseases is the specialist in skin and venereal diseases . But also urologists and gynecologists ( gynecologists ).

In addition to venereology, infectious diseases also deal with sexually transmitted diseases.

Experts from all relevant medical fields, including epidemiology and social sciences, have come together in the German STI Society (DSTIG) . The DSTIG organizes public specialist congresses and advanced training events.

frequency

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The frequency of sexually transmitted infections has increased again after a nadir in the 1990s. In particular, gonorrhea, syphilis, and chlamydial infections have increased in high-income countries and among homosexual men. One reason for the increase is the development of resistance e.g. B. the gonococcus against antibiotics. This also applies to non-classic STIs such as Shigella. Newly discovered pathogens such as the Zika virus also contribute to the increase. In addition, there is the spread of special sexual practices such as "chem sex" (increasing sexual experience through drugs).

Since the population still sees HIV infection as a problem for marginalized groups, many people see it as a calculable risk and protected sexual intercourse with condoms is again being viewed more as a means of contraception and less as a means of preventing infections with sexually transmitted diseases.

Therefore, according to recent surveys, for. In England, for example, the number of syphilis cases has increased by 13 times in less than six years, cases of gonorrhea increased by 86 percent, and the number of chlamydia infections doubled. In the Netherlands , health authorities recorded an 80 percent increase in syphilis within twelve months. In Germany , the number of syphilis cases doubled between 2000 and 2002 to around 2,300 cases. All federal states recorded an increase, with metropolitan areas and large cities such as Berlin, Hamburg, Munich, Frankfurt and Cologne being particularly affected. More than 85 percent of those newly infected are men, especially in the age group 25 to 39 years. The increase in new infections is highest among homosexual men.

After the end of communism in Eastern Europe , the “classic sexually transmitted diseases” became very common again in the former Eastern Bloc countries , which also resulted in more cases of illness in their neighboring countries.

The infection rate also increased in the older age groups neglected in the studies.

WHO figures from 1990 worldwide
Number of new cases Incidence
Trichomoniasis 170 million
Chlamydia 50 million
HIV 40 million (2000)
Human papillomavirus 30 million
Gonorrhea 25 million
Genital herpes 20 million
syphilis 4 million
Hepatitis B. 2 million
Ulcus molle ?

Prevention and therapy

Even with the greatest possible safety precautions, infection cannot be ruled out if one of the partners has an infection - possibly without knowing it. Changing partners plays an important role in the risk of infection through intimate contact. Healthy sexually active people who live in monogamous relationships are not affected. Many people consider the possibility of being infected to be an acceptable basic risk and neglect possible prevention through medical care. Constant use of condoms can significantly limit the spread of sexually transmitted diseases . Each responsible but people also have the option open, before examining a first intimate contact with a new partner as a precaution by a specialist in skin and venereal diseases or a gynecologist (gynecologist) and to seek treatment if necessary, and the health department free and anonymous one HIV To take test . If this safety precaution is used by both partners, the main route of transmission for this type of infection is eliminated, so that the use of condoms as protection against infection can be dispensed with.

The hepatitis B vaccination reduces the risk of infection with hepatitis B and lowers simultaneously with an infection the severity of the disease. The Standing Vaccination Commission ( STIKO ) has therefore included the hepatitis B vaccination in its recommendations for regular vaccination protection for children and adolescents.

The introduction of antibiotics enables many of these diseases to be successfully treated, especially if they are detected early (HIV infection is an exception). However, the medication prescribed by the specialist must be consistently used by both partners at the same time in order to prevent reinfection through the ping-pong effect .

Prevention through information

American poster from World War II addressed to soldiers . The soldiers should be motivated by the message “You can not defeat the Axis powers if you are infected with sexually transmitted diseases ” (You can't beat the Axis if you get VD) to pay attention to the prevention of sexually transmitted diseases out of patriotism . At that time, pictures of pretty women were often used as eye-catchers for such posters.

A responsible approach to the dangers of sexually transmitted diseases is to be promoted through early information to schools and public advertising campaigns ("protect condoms"). No public information is provided about which specialists for girls and women or boys and men are responsible for precautionary examinations or examinations in suspected cases and that patient files are generally subject to data protection.

STD or STI?

In the English-speaking world in particular, the term STI (sexually transmitted infection) is increasingly used instead of the term STD (sexually transmitted disease). Proponents of this use of the word argue that people who are already infected can infect other people without the infected having already developed any symptoms of the disease, and thus this is a broader definition. Opponents of the renaming, however, reply that the term disease sounds more threatening to non-infected people than the term infection and should therefore be preferred.

See also

literature

  • Birgit Adam : The punishment of Venus. A cultural history of venereal diseases. Orbis, Munich 2001, ISBN 3-572-01268-6 .
  • Gundolf Keil : Venereal Diseases (Antiquity and Middle Ages). In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil, Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 482 f.
  • René Burgun and Paul Laugier: The History of Venereal Diseases. In: Illustrated History of Medicine. German arrangement by Richard Toellner a . a. Special edition. Salzburg 1986, Volume III, pp. 1448-1511.
  • Dominique Puenzieux, Brigitte Ruckstuhl: Sexuality, Medicine and Morality. The fight against venereal diseases syphilis and gonorrhea. Zurich 1994.
  • Lutz Sauerteig: Illness, Sexuality, Society, Venereal Diseases and Health Policy in Germany in the 19th and 20th Century. Stuttgart 1999.
Historical literature
  • Julius Rosenbaum : History of the lust epidemic in antiquity for doctors, philologists and antiquity researchers. Hall 1839; 7th, revised edition, enlarged with an appendix, Verlag von H [ermann] Barsdorf, Berlin 1904 (title: History of the lust epidemic in antiquity together with detailed studies on the Venus and phallic cults, brothels, Νοῦσος ϑήλεια of the Scythians, paederasty and other sexual ones The debauchery of the ancients is represented as contributions to the correct explanation of their writings. ) Reprint: Central antiquariat of the German Democratic Republic, Leipzig 1971 (edition for S. Karger, Basel / Munich /…).

Web links

Wiktionary: STD  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ↑ Birgit Adam : The punishment of Venus. A cultural history of venereal diseases. Orbis, Munich 2001, ISBN 3-572-01268-6 , p. 92.
  2. ^ A b Peter Fritsch: Dermatology and Venereology. 2nd Edition. Springer Verlag, 2004, ISBN 3-540-00332-0 .
  3. ↑ ifsg law for the prevention and control of infectious diseases in humans (Infection Protection Act - IfSG) Federal Ministry of Health of the FRG
  4. ↑ Implementation of the notification in accordance with Section 7 (3) of the Infection Protection Act
  5. ↑ The renaissance of venereal diseases. on: Medizinpopulaer.at
  6. ↑ Notifiable diseases . ( Memento from March 13, 2013 in the Internet Archive ; PDF; 227 kB) Federal Ministry for Health and Women of the Republic of Austria
  7. ↑ Werner Rn, Gaskins M, Nast A, Dressler C: Incidence of Sexually Transmitted Infections in Men Who Have Sex With Men and Who Are at Substantial Risk of HIV Infection - A Meta-Analysis of Data From Trials and Observational Studies of HIV Pre- Exposure prophylaxis. December 3, 2018, accessed June 1, 2020 .
  8. ↑ Deborah A. Williamson, Marcus Y. Chen: Emerging and Reemerging Sexually Transmitted Infections . In: New England Journal of Medicine . tape 382 , no. 21 , May 21, 2020, ISSN  0028-4793 , p. 2023–2032 , doi : 10.1056 / NEJMra1907194 ( nejm.org [accessed June 1, 2020]).
  9. ↑ David W Eyre, Katy Town, Teresa Street, Leanne Barker, Nicholas Sanderson: Detection in the United Kingdom of the Neisseria gonorrhoeae FC428 clone, with ceftriaxone resistance and intermediate resistance to azithromycin, October to December 2018 . In: Eurosurveillance . tape 24 , no. March 10 , 7, 2019, ISSN  1025-496X , doi : 10.2807 / 1560-7917.ES.2019.24.10.1900147 , PMID 30862336 , PMC 6415501 (free full text).
  10. ↑ Kenya Murray, Vasudha Reddy, John S. Kornblum, HaeNa Waechter, Ludwin F. Chicaiza: Increasing Antibiotic Resistance in Shigella spp. from Infected New York City Residents, New York, USA . In: Emerging Infectious Diseases . tape 23 , no. 2 , 2017, ISSN  1080-6040 , p. 332-335 , doi : 10.3201 / eid2302.161203 , PMID 28098543 , PMC 5324786 (free full text).
  11. ↑ D'Ortenzio E, Matheron S, Yazdanpanah Y, de Lamballerie X, Hubert B: Evidence of Sexual Transmission of Zika virus. June 2, 2016, accessed June 1, 2020 .
  12. ↑ VL Gilbart, I Simms, C Jenkins, M Furegato, M Gobin: Sex, drugs and smart phone applications: findings from semistructured interviews with men who have sex with men diagnosed with Shigella flexneri 3a in England and Wales: Table 1 . In: Sexually Transmitted Infections . tape 91 , no. 8 , December 2015, ISSN  1368-4973 , p. 598–602 , doi : 10.1136 / sextrans-2015-052014 ( bmj.com [accessed June 1, 2020]).
  13. ↑ LJ Brant, A. Bukasa, KL Davison, J. Newham, JA Barbara: Increase in recently acquired syphilis infections in English, Welsh and Northern Irish blood donors. In: Vox Sanguinis. 2007 July; 93 (1), pp. 19-26., Doi: 10.1111 / j.1423-0410.2007.00923.x
  14. ↑ AT Bodley-Tickell, B. Olowokure, S. Bhaduri, DJ White, D. Ward, JDC Ross, G. Smith, HV Duggal, P. Gool: Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system. In: Sexually Transmitted Infections. 2008; 84, pp. 312-317, doi: 10.1136 / sti.2007.027847
  15. ↑ J. Mati: Family planning, sexually transmitted diseases and AIDS. In: Family planning, health and family well-being. United Nations, Population Division, 1996, pp. 213–223, abstract ( Memento from December 10, 2008 in the Internet Archive )