Sexually transmitted diseases (STDs), also known as sexually transmitted infections (STIs) are infectious diseases that you can develop due to having sex with an infected partner. Many of these can be transmitted not only by typical sexual intercourse but also via oral sex or any sexual contact with the mouth, anus, vagina, or penis. Sexually transmitted infections are very common in South Africa and throughout the world. STDs can be caused by bacteria, viruses, or parasites, and can have multiple symptoms, mostly involving pain, burning, itching, bumps or blisters, and abnormal bleeding or discharge involving the penis or vagina. However, many infections may not have any symptoms at all. Untreated STDs can cause long-term complications, including infertility, psychosis, pelvic inflammatory disease, organ damage, AIDS, cancer, and even death. The most common STDs include:
Most sexually transmitted infections can be treated/cured with anti-infective medications. However, some, such as HIV and HPV, cannot be cured.
Also known as “antibiotics,” are used to treat several sexually transmitted infections, including chlamydia, gonorrhoea, syphilis, and bacterial vaginosis. In most cases, these infections can be cured in a single dose, either given by mouth or as an injection/shot. When the patient cannot tolerate the single-dose medication, a different antibiotic will be used, usually once or twice daily for several days. Antibiotics work by killing bacteria or limiting their growth in the body.
Examples of antibiotics that can be given as a single dose to treat several STDs include azithromycin, penicillin, ceftriaxone, and cefixime. Other antibiotics that can be used, usually in multiple doses, include doxycycline, metronidazole, clindamycin, levofloxacin, amoxicillin, metronidazole, moxifloxacin, probenecid, and gentamicin. Sometimes, depending on the infection, treatment with more than one antibiotic at one time may be needed. The length of treatment will also vary depending on the type and severity of infection and may be from a few days, up to 3 weeks.
Are used to treat human immunodeficiency virus (HIV), human papillomavirus (HPV), genital warts, herpes simplex virus (HSV)/”herpes,” and hepatitis B. Unlike bacterial sexually transmitted infections, most of these infections can NOT be cured, but antiviral treatment can help control symptoms and decrease viral load, improving quality of life, and decreasing the risk of passing the infection to a sexual partner. It is important to remember that it is still possible to pass viral STDs to a sexual partner even when taking antiviral therapy. Antiviral Medications work by interrupting one or more stages of the viral life cycle.
Different types of antiviral medications are used to treat different types of viral STDs
Some examples of antiviral medications used to treat HSV infections include acyclovir, famciclovir, and valacyclovir. These may be used for a few days to treat a herpes outbreak, or long-term to decrease the number of outbreaks.
Examples of antiviral medications used to treat HIV infections include tenofovir, abacavir, ritonavir, emtricitabine, lamivudine, efavirenz, maraviroc, and raltegravir. HIV treatment is always given as daily, long-term therapy, and usually includes three medications of different classes to suppress the virus effectively. Some combination pills containing more than one medication are available.
Antiviral treatment of HPV is usually not recommended, except in severe cases. However, topical treatments to help remove genital warts caused by HPV can be used. Examples include imiquimod, podofilpox, and liquid nitrogen.
Treat sexually transmitted infections caused by parasites, such as trichomoniasis, pubic lice, and scabies. The treatments for trichomoniasis are also antibacterial medications that may be used to treat other STDs. Examples are metronidazole and tinidazole.
Treatment for pubic lice and scabies typically involves the application of a pediculicide topically and washing the affected area thoroughly. Each product has specific instructions for use. Oral medication is also available that can help in cases that the topical treatment doesn’t eliminate. These medications work by killing lice, scabies mites, and their eggs. Examples of antiparasitics/pediculicides used to treat STDs include ivermectin, permethrin, pyrethrins and piperonyl butoxide, malathion, and lindane.
The most common side effects to be expected with these medications are nausea/vomiting, diarrhoea, dizziness, headache, and skin irritation (topical medications). If you develop a rash or hives or trouble breathing, this could be a sign of an allergic reaction, and you should seek medical attention. Long-term therapy, with antivirals especially, may cause lab abnormalities or organ damage, so it is important to follow up with your healthcare provider regularly. Many of these medications may interact with others, so it is important that your doctor and/or pharmacist know all the medications you are taking.
Even though some STDs can be easily treated with antibiotics, others cannot be cured and have life-threatening complications. The best way to prevent contracting a sexually transmitted infection is to practice safe sex. Always use a condom, and do not engage in sexual activity with a person known or suspected to have an STD. If you are diagnosed with an STD, it is important that you contact any sexual partners you have had within the past several weeks so that they can be tested and treated for the disease, too. There is a vaccine available that provides protection against some strains of HPV, which can cause genital warts and cancer. If you are at high risk of contracting HIV, you should talk to a health care provider about medication regimens that may be used for pre-exposure prophylaxis/prevention, also known as “PrEP.” If you are sexually active, especially if you have more than one sexual partner, it is important to be screened/tested for STDs regularly, especially since many life-threatening infections often do not have any symptoms.