Sex, Gender & Sexuality: Sexually Transmitted Diseases Research Paper Starter

Sex, Gender & Sexuality: Sexually Transmitted Diseases

Sexually transmitted infections are common and in most instances preventable. Bacterial infections like chlamydia, gonorrhea, and syphilis are discussed below as are the Herpes Simplex Viruses, the human papillomavirus, and the human immunodeficiency virus. Descriptions of symptoms, treatments, current rates of infection, and populations affected are provided. The controversy surrounding the newly recommended vaccination against the human papillomavirus (HPV) is also discussed as is the societal need to combine efforts at prevent infections.

Keywords Acquired Immunodeficiency Syndrome (AIDS); Chlamydia; Gonorrhea; Herpes Simplex Viruses; Human Immunodeficiency Virus (HIV); Human Papillomavirus (HPV); Sexuality; Sexually Transmitted Diseases; Sexually Transmitted Infections; Syphilis

Sexually Transmitted Diseases

Overview

Sex is presented in magazines and other media as something everyone should be doing. Teenagers giggle about it; their parents are embarrassed by it, and various cultures treat it like a gift. Underneath the emotion and exhilaration of sexuality hides a reality unique only to sexual activity itself. According to the World Health Organization in 2013 there are 499 million new curable sexually transmitted infections (like syphilis, gonorrhoea, chlamydia and trichomoniasis) every year. That these cases are curable means that with a timely diagnosis and proper treatment, these infections can be eradicated. Those that are not diagnosed early or treated properly make up an entirely different statistic.

Sexually transmitted infections (STIs) can be spread from person to person through anal, oral, or vaginal intercourse or passed from mother to child during pregnancy or delivery. STIs come in the form of bacteria, parasites, or viruses, with the latter remaining in its host indefinitely. While most bacterial forms of STIs (chlamydia, gonorrhea, and syphilis) can be eliminated with a dose of an antibiotic, the lasting effects of an untreated infection can cause pelvic inflammatory disease, infertility, and more serious conditions for infants born to infected mothers. The viral forms of STIs include the human papillomavirus, herpes simplex virus, and human immunodeficiency virus (HIV), which causes the severe complications noted in acquired immunodeficiency syndrome (AIDS). There are antiviral medications that can decrease the effects of viral outbreaks, shortening symptoms and lessoning the number of outbreaks, but there is no cure for the viruses acquired through sexual intercourse.

Many people become infected and never know it. As a result, infections are transmitted without the knowledge of either partner, and those infections do damage in hiding. For most people, however, the symptoms of an STI are acute and obvious. For example, many infected individuals note an unusual discharge, sores known as ulcers on the affected area, genital or lymph node swelling, and pelvic pain. In some cases, fever and cold-like symptoms also appear. Some people experience symptoms right away while others may not note symptoms for weeks, sometimes years, after initial infection.

The only way to avoid acquiring a sexually transmitted infection is to abstain from all types of sexual intercourse or to have monogamous intercourse with an uninfected partner. Male latex condoms are an effective way to avoid an infection (when used consistently and correctly), but they do not guarantee safety, as a condom may not fully cover an affected area.

Prevalence

In 2013 the US Centers for Disease Control and Prevention reported that there are 20 million new STIs annually, with a total of 100 million across the country. The most common STIs are chlamydia, gonorrhea, hepatitis B virus, herpes simplex virus type 2, HIV, human papillomavirus (HPV), syphilis, and trichomoniasis. For example, in the world's poorest countries, where access to condoms, screening, and treatment are limited (or nonexistent), unsafe sex ranks second only to being underweight for causing the population's disease, disability, or death rates (p. 1597). It should be noted that unsafe water and sanitation are ranked third. When one's water supply poses less of a health risk than having sex, the importance of the problem should be clear.

Further Insights

The Common Infections

Chlamydia

Chlamydia is the most commonly reported sexually transmitted infection, with almost three million Americans infected with it each year. It is probable that this statistic is inaccurate as many people who suffer from the bacterial infection do not appear or feel symptomatic, and therefore, do not get screened for it. If diagnosed early, an antibiotic can clear the infection; if the infection remains undetected, however, Chlamydia can cause infertility in both men and women. It can also cause swelling in the prostate and painful urination in men. In women, the infection can cause pelvic inflammatory disease, chronic pain during intercourse and/or urination, and it can cause eye infections and pneumonia in babies through mother to infant transmission during pregnancy or delivery.

As young adults between the ages of fifteen and twenty-four are the most prolific population to acquire the infection, it is recommended that anyone under the age of twenty-five have a yearly screen as well. In addition, anyone who is pregnant or who is sexually active and experiences pain during intercourse or urination or has an abnormal discharge should be screened as well ("Common STD Risky," 2008).

Human Papillomavirus (HPV)

The human papillomavirus (HPV) is the most common STI in the United States and there is no treatment for it. Once infected with HPV, a person’s immune system will clear most HPV within two years, while the disease can still persist in some cases. There are over ten types of high-risk forms of HPV, with types HPV-16 and HPV-18 causing the majority of HPV-caused cancers; most high-risk forms of HPV will not cause cancer. HPV is sexually transmitted through anal, oral, and vaginal intercourse, and it is important to note that no sexual activity is less risky than another.

There is an FDA-approved vaccination for the HPV-16 and HPV-18 viruses. However, as with all vaccines, Gardasil and Cervarix (the brand names of two vaccines) brought some controversy. First, Gardasil was approved for young women, not young men. Therefore, while young women can become vaccinated for the HPV-16 and HPV-18 strains, men cannot, which leaves an entire population of people without protection. Second, the vaccine is recommended for young women prior to becoming sexually active. This means that to be effective, the vaccine should be administered prior to girls becoming teenagers, generally between their tenth and twelfth years. This recommendation comes from the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians (Iannelli, 2007).

As with most vaccines, a recommendation is not the same as a requirement. In addition, while requiring the vaccine would ensure that young women become protected from cervical cancer, many people could argue that having any defense from a sexually transmitted disease forced upon them is an unconscionable way to offer that protection.

In 2007 it was reported that 47 percent of high school students report having had sexual intercourse, and 34 percent of sexually active students said that they didn't use a condom the last time they had; the CDC also reported that over 14 percent of women who were 18 to 25 with only one lifetime sex partner still had HPV infections (Ianelli, 2007, "Necessity").

In other words, about one in eight young women who have sexual intercourse only once with only one person will still develop an HPV infection; this statistic includes young women who only have oral sex as well. In the chance that HPV develops into cancer, it is possible that someone infected at the age of fifteen would not develop cervical cancer until much later in her life. Yearly gynecological exams (including pap smears) can detect the abnormal cells related to cervical cancer, and early steps like biopsies and excisional procedures (Clifford, Smith, Aguado & Franceschi, 2003, as cited in Cox et al., p. 856) can be taken to halt the development of cancer, but until all young women have easy access to yearly exams and post-diagnosis procedures, the vaccine may be the best option.

Gonorrhea

Much like Chlamydia, Gonorrhea is a bacterial infection that can be treated with an antibiotic. In contrast to the former infection, however, the latter is showing resistance to many antibiotic treatments, making it a potential health hazard in America. According to the CDC in 2012, 820,000 Americans get new gonorrheal infections annually. Gonorrhea can cause no symptoms, making its detection difficult in many cases. When diagnosed, it is usually because symptoms like inflammation in the genitals and reproductive organs, painful urination, or unusual discharge from the vagina or penis are noted (Gonorrhea - CDC Fact Sheet). The infection can be transmitted to infants from their mothers, can cause infertility, and can spread to the blood and joints. In addition, gonorrhea infection raises the risk of acquiring the human immunodeficiency virus (HIV) for anyone who is sexually active (Gonorrhea - CDC Fact Sheet).

Statistically, gonorrhea rates in the United States indicate a higher prevalence in African Americans (than in whites) and in women more than men (CDC Surveillance, 2006). Various antimicrobials (antibiotics) have been used against the gonorrhea bacteria. However, since the early 1930s, the bacteria has changed enough to become resistant to several of these remedies, including Penicillin and other sulfa drugs (Workowski, Berman & Douglas, 2008, p. 606). The regime of cephalosporin treatment works effectively and efficiently; however, as many drugs that have been used in the past fall victim to a stronger bacteria, it is necessary that other options be explored in case resistance occurs for cephalosporin as well (Workowski, Berman & Douglas, 2008, p. 609).

Persons with identifiable risk factors should be screened for gonorrhea, as early detection is the best way to prevent complications from the infection, which decreases the possibility of medicinal resistance. According to the United States Preventive Task Force, women who are pregnant, are younger than 25, who have had a previous gonorrhea or other STD/STI, who have had multiple sex partners, who have used condoms inconsistently, who use drugs, and who are are commercial sex workers should be tested for gonorrhea (U.S. Preventive Services Task Force, 2005). In addition, men who have sex with men should also be tested, especially those with HIV (CDC: CDC: Updated Recommendations). Likewise, anyone in these risk categories should be screened for all other STIs and STDs as well (CDC: Updated Recommendations).

Herpes Simplex Virus

According to Associate Professor of Nursing, Janelle Gardner (2006), the "strongest predictor" of genital herpes is "multiple sexual partners" (p. 26). In other words, contracting the herpes simplex virus (HSV) can be predicted based on whether or not a person has more than one sexual partner in his or her lifetime. Having sex with only one person is risky; that risk increases with every additional sex partner because each new person brings in a risk from someone else, and the numbers multiply quickly, whether the intercourse is oral, anal, or vaginal across partners. By 2013 approximately 776,000...

(The entire section is 5107 words.)