Sexually Transmitted Diseases and Relationships

Sexually transmitted diseases (STDs), which are also referred to as sexually transmitted infections (STIs), are illnesses that have a significant probability of transmission in humans through sexual contact, including penile-vaginal intercourse, oral-genital contact, oral-anal contact, and penile-anal sex. Some STDs can also be spread via skin-to-skin contact such as rubbing or petting, childbirth, breastfeeding, and sharing needles. STDs have been in existence for hundreds of years.

There are several types of STDs, including bacterial, viral, fungal, protozoal, parasitic, and enteric infections. The incidence rates of STDs remain high in most of the world; however, proper therapeutic treatment can cure most of these. The widespread dissemination of antibiotics for a number of bacterial infections has resulted in mutations in some bacterial forms of STDs, producing strains [Page 1478]that are resistant to traditional drug therapies. These strains often require more aggressive treatments with potent antibiotics and are typically more costly than traditional treatments. Many STDs, particularly in women, do not cause symptoms. Therefore, asymptomatic individuals may unknowingly transmit an STD to their sexual partner(s).

In the United States, chlamydia is the most frequently reported bacterial sexually transmitted disease. In 2006, for example, 1,030,911 chlamyd-ial infections were reported to the Centers for Disease Control and Prevention (CDC) from 50 states and the District of Columbia. Gonorrhea is the second most commonly reported STD. The CDC estimates that more than 700,000 persons in the United States get new gonorrheal infections each year. Only about half of these infections are reported to CDC. In 2006, for instance, 358,366 cases of gonorrhea were reported to CDC. Other STDs, including the Human Immunodeficiency Virus (HIV), are less common but still prevalent within the United States. According to the CDC, adolescents and young adults under the age of 25 years are most likely to be infected with STDs, although there has been a rise in prevalence among older adults in recent years. Many scientists believe that the increased rates of STD, including HIV, among older adults are related to the prevalence of divorce and the increase in life expectancy. Older adults may be more likely than ever before to be dating and having sex with new partners. However, these same individuals may be less likely to use condoms or be tested for STDs because they came of age in generations prior to the HIV pandemic and STD education and prevention campaigns.

Although the proper and consistent use of male latex condoms has proved to greatly reduce the likelihood of STD transmission, condom usage rates remain low. Among individuals who do use condoms, condom use errors may result in failures that place individuals at risk for disease exposure and transmission. Common condom errors identified in research include condom breakage, slippage, and using the same condom for multiple sexual behaviors within a sexual event (e.g., vaginal and anal intercourse). One explanation for the lack of condom use is attributed to condom negotiation skills. In new relationships, individuals may be embarrassed to explicitly discuss sexual behaviors, which may make it unlikely that condom use will be negotiated. Individuals also report that discussing condom use decreases the spontaneity of a sexual event—they ruin the mood. Further, many men and women do not like to use condoms because of the way that they feel. For example, some men find it more difficult to maintain an erection when using condoms, while women often report that condoms dry out natural vaginal lubrication, making sex uncomfortable.

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