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There are several types of sexually transmitted diseases (STD), also known as venereal diseases that we must be aware of. This week, we highlight the topic of STDs to mark the World Aids Day on 1st December. Many people are familiar with the most prominent STD - AIDS. However, many other STDs affect millions of men and women each year. Many of these STDs reveal no symptoms in the early stages, especially in women. When the symptoms do develop, they may be confused with those of other diseases that are not transmitted through sexual contact. STDs can still be transmitted from one person to another even if there are no symptoms. Also, health problems caused by STDs tend to be more severe for women than for men. In recent years, the term sexually transmitted infections (STI) is preferred as it has a broader meaning: a person can be infected, or potentially infect others, without having a disease. Some cases of HIV are contracted through childbirth, breastfeeding or the use of IV drug needles once used by an infected person.
The Brunei Darussalam AIDS Council (BDAC), founded in 2000, reported that there are 61 AIDS cases in Brunei and new cases this year. Sadly, students at the age of 12 years old are getting infected with STD and such casual behaviours are precursors to possible AIDS infections. The BDAC is a non-Profit Organisation whose main objective is to raise awareness on HIV & AIDS in the country. It aims to educate the public on issues related to sexually transmitted infections, teenage pregnancy & social issues.
STD prevention requires changing the behaviours that place people at risk for infection. Hopefully, by understanding the type of common STDs that can be easily contracted, individuals can reduce their risk of becoming infected with STDs or, if one is already infected, avoid infecting others.
If anyone living in Brunei has questions or need help on any related issues regarding AIDS or any other sexually transmitted infections, they can consult a doctor or contact the Brunei Darussalam Aids Council on their phone line: +673-2345573, or e-mail: penyinarbdac@gmail.com, they will be more than willing to assist with the utmost discretion. More information about the organisation can be obtained from their Facebook page or website.
Below are the descriptions of several of the most common STDs including information about incidence, symptoms (if any), and treatment. But remember the old adage - prevention is better than cure, and better be safe than sorry. * Information extracted from the American Centers for Disease Control and Prevention. 
HIV
What it is . The human immunodeficiency virus (HIV), the cause of AIDS.
| How many have it . An estimated 40,000 Americans are infected with HIV each year, most through sexual contact. An estimated 850,000 to 950,000 people in the U.S. are living with HIV/AIDS. According to the United Nations, more than 30 million people around the world have died of AIDS-related diseases. | Signs . Many people who have HIV don't even know it because symptoms may not appear for an average of ten years. Others experience unexplained weight loss, flu-like symptoms, diarrhea, fatigue, persistent fevers, night sweats, headaches, mental disorders, or severe or recurring vaginal yeast infections. | How it spreads . Through unprotected vaginal, oral and anal sex, and breast milk, and also through sharing contaminated syringes. During vaginal intercourse, the risk of becoming infected with HIV is higher for women than for men. An infected woman can also pass HIV to her baby during pregnancy, delivery, or breastfeeding. There is NO cure for AIDS. |
| Treatment . Antiviral medications can slow progression of the infection and delay the onset of AIDS symptoms. Early treatment can make a big difference. | Possible consequences . It can weaken the body's ability to fight disease, making someone vulnerable to certain cancers and infections such as Pneumocystis carinii pneumonia. Without treatment, 20% to 30% of babies born to HIV-positive women will have HIV, but treatment can reduce that rate significantly—by 67%. | Testing . Swab cell culture from inside of mouth, blood test or urine test. |
CHLAMYDIA
What it is . A bacterial infection of the genital area.
| How many have it . About 3 million new cases each year. The highest rates are among women aged 15 to 19. | Sign . There are no symptoms in most women and many men who have it. Others may experience abnormal vaginal bleeding (not your period), unusual discharge or pain during urination within one to three weeks of having sex with an infected partner. | How it spreads . Through unprotected vaginal, oral, or anal intercourse. |
| Treatment . Oral antibiotics cure the infection. Both partners must be treated at the same time to prevent passing the infection back and forth, and both partners need to abstain from intercourse until the infection is gone. | Possible consequences . Infertility and increased risk of HIV infection. In women, chlamydia can lead to pelvic inflammatory disease (PID) and tubal (ectopic) pregnancy. | Testing . Swab cell culture or discharge sample from the throat, cervix, anus, or urethral opening of the penis; swab DNA test or urine test. |
TRICHOMONIASIS
What it is . A parasitic infection of the genital area.
| How many have it . As many as 5 million new cases each year. | Signs . Often there are no symptoms, especially in men. Some women notice a frothy, smelly, yellowish green vaginal discharge, and/or genital area discomfort, usually within four days to one month after exposure to the parasite. Men may notice a discharge from the penis. | How it spreads . Through unprotected vaginal intercourse. |
| Treatment . Antibiotics can cure the infection. Both partners have to be treated at the same time to prevent passing the infection back and forth, and need to abstain from intercourse until the infection is gone. | Possible consequences . Increased risk of HIV infection and, in women, complications during pregnancy. Also, it's common for this infection to happen again and again. | Testing . Swab from vaginal and penile secretions. |
GONORRHEA
What it is . A bacterial infection of the genital area.
| How many have it . Approximately 650,000 new cases a year. The highest rates are among women aged 15 to 19. | Signs . Most people infected have no symptoms. For those who do, it can cause a burning sensation while urinating, green or yellowish vaginal or penile discharge, and for women, abnormal vaginal bleeding and/or pelvic pain. Symptoms can appear within two to ten days after infection. | How it spreads . Through unprotected vaginal,oral, or anal sex. |
| Treatment . Oral antibiotics. Both partners must be treated at the same time to prevent passing the infection back and forth back and forth—and both partners need to abstain from unprotected intercourse until the infection is gone. | Possible consequences . Sterility and increased risk of HIV infection. In women, the infection can spread into the uterus and fallopian tubes, causing PID, tubal (ectopic) pregnancy, complications during pregnancy and infant blindness or meningitis. | Testing . Swab cell culture or discharge sample from the throat, cervix, anus, or urethral opening of the penis; swab DNA test; urine test. |
GENITAL HERPES
What it is . A viral infection of the genital area, and sometimes around the mouth.
| How many have it . About 1 million new cases each year. An estimated 45 million cases already exist. | Signs . Most people have no symptoms. Herpes 1 causes cold sores and fever blisters on the mouth but can be spread to the genitals. Herpes 2 is usually on the genitals, but can be spread to the mouth. An outbreak can cause red bumps that turn into painful blisters or sores on genitals and elsewhere. During the first attack, it can also lead to flu-like symptoms: fever, headaches, and swollen glands. Symptoms usually appear within two weeks of infection. | How it spreads . By touching an infected area (infected areas may not always be noticeable) or having unprotected vaginal, oral, or anal intercourse. Warning: Some people may be contagious even when they don't have symptoms. |
| Treatment . There is NO cure. An antiviral drug can help the pain and itching and also reduce the frequency of recurrent outbreaks. | Possible consequences . Recurrent sores (the virus lives in the nerve roots and keeps coming back). Passing herpes from mother to newborn is rare. However, an infant who gets herpes can become very ill, so some precautions are advisable. | Testing . If symptoms are present, by visual exam or through examination of a swab from a lesion. There are also blood tests that can identify antibodies for the virus; however, most blood tests for herpes cannot distinguish between type 1 and type 2. |
SYPHILIS
What it is . An infection caused by small organisms, which can spread throughout the body.
| How many have it . About 70,000 new cases a year. | Signs . In the first phase, a single sore (chancre) may appear on the genitals or mouth several weeks to three months after exposure, lasting for one to five weeks. Often, however, there are no noticeable symptoms. In the second stage, up to ten weeks after the first sore has disappeared, a variety of symptoms can appear, including a rash (often on the palms of the hands, soles of the feet, or genital area). | How it spreads . Through unprotected vaginal, oral, or anal sex and also through kissing, if there is a lesion on the mouth. |
| Treatment . Antibiotic treatment can cure the disease if it's caught early, but medication can't undo damage already done. Both partners must be treated at the same time. | Possible consequences . Untreated, the symptoms will disappear, but the infection stays in the body and can progress into the third stage, damaging the brain, heart, and nervous system, and can cause death. Syphilis in women can seriously harm a developing fetus during pregnancy. | Testing . Blood test; swab sample from a sore or lesion. |
HEPATITIS B VIRUS (HBV)
What it is . A viral infection affecting the liver.
| How many have it . About 77,000 new cases a year acquired through sexual transmission. About 750,000 people are already infected with hepatitis B as a result of unprotected sexual activity. | Signs . Many people don't have any symptoms. Others may feel tired or have aches, nausea and vomiting, loss of appetite, darkening of urine, or tenderness in the stomach, usually within one to six months of exposure. Yellowing of the skin and the whites of the eyes (called jaundice) can occur later. | How it spreads . Through unprotected vaginal, oral, or anal sex; through sharing contaminated needles or any behavior in which a person’s mucous membranes are exposed to an infected person’s blood, semen, vaginal secretions, or saliva. The chance of getting it through kissing is low. |
| Treatment . Most cases clear up within one to two months without treatment, during which time you should not drink alcohol until liver function returns to normal. Some people are contagious for the rest of their lives. A three-dose vaccine is now available. | Possible consequences . Chronic, persistent inflammation of the liver and later cirrhosis or cancer of the liver. If you are pregnant, your baby must be immunized at birth. | Testing . Blood test; a three-dose vaccination is also available to protect against infection if it has not already occurred. There is also a combined three-dose vaccine for both hepatitis A and B. |
HUMAN PAPILLOMAVIRUS (HPV OR WARTS)
What it is . A viral infection with more than 100 different types, primarily affecting the genital area, both inside and out.
| How many have it . An estimated 5.5 million new cases each year. At least 20 million people already have it. | Signs . Soft, itchy warts in and around the genitals (vagina, penis, testicles, and anus) may appear two weeks to three months after exposure. Many people, however, have no symptoms but may still be contagious. | How it’s spread . Through unprotected vaginal, oral, or anal intercourse, or by touching or rubbing an infected area (infected areas may not always be noticeable). |
| Treatment . There is NO cure. Warts can be removed through medication or surgery, but even with such treatments, the virus stays in the body and can cause future outbreaks. | Possible consequences . Increased risk of genital cancer for men and women. The most common form of cervical cancer in women is caused by some of these virus types. | Testing . For women, with and without symptoms, who have an abnormal or ambiguous pap smear, a follow-up cervical swab DNA test can detect HPV infection on the cervix only. The FDA-approved DNA test can tell a woman if she has HPV, identify the type of HPV that she has, and tell her whether it is one associated with cervical cancer (not usually the same types of HPV that are associated with genital warts). The HPV DNA test is not a reliable test for men. |
