31.1  Introduction to sexually transmitted infections (STIs)

Sexually transmitted infections (STIs) is a term used to describe more than 20 different infections that are transmitted mainly through sexual contact via the exchange of semen, vaginal fluid, blood and other fluids; or by direct contact with the affected body areas of people with STIs. Sexually transmitted infections are also called sexually transmitted diseases (STDs) or venereal diseases. In this study session, we will be talking about STIs in general, with particular emphasis on their impact on individual health. You will also appreciate the implications of preventing STIs in reducing HIV transmission, and the complications resulting from untreated STIs.

STIs are very common. The most widely known are gonorrhoea, chlamydia, syphilis and HIV. STIs can cause serious and permanent complications in infected people who are not treated in a timely and effective way. In people with untreated STIs, the complications and long-term consequences can be devastating. The social and economic burden of STIs can be enormous. Untreated STIs can lead to loss of employment and broken marriages. STIs can place a heavy financial burden on families, communities and health services.

Prevention campaigns in order to reduce the incidence of STIs have a marked impact on the general health of the population. Effective prevention of STIs reduces complications that are life threatening for the infected individual, and decreases economic and psychosocial problems associated with the complications arising from STIs.

Fewer STIs means fewer complications like pelvic inflammatory disease (PID), inflammation of the uterus and fallopian tubes due to bacterial infection or other pathogens), infertility, ectopic pregnancy (pregnancy outside of the uterus), etc. as well as decreased rate of HIV transmission during unprotected sexual contacts.

For patients who are HIV-negative, or who have not been tested, the presence of an STI is an important indication to trigger testing (or repeat testing). Because STIs and HIV infection frequently co-exist and are transmitted together, anyone seen for an STI should be offered HIV testing and counselling. So you should refer any patient presenting with STIs for HIV counselling and testing services.