Sex is fun and healthy. But sometimes coitus is followed by a rude awakening. That is when pathogens go on a journey and look for a new host. However, they only succeed during unprotected intercourse. The history of venereal diseases is probably as old as mankind. It was not always known by what means they were transmitted, and they were often interpreted as just divine punishment for all-too-human vices.
Ignorance enables dissemination
To this day, STDs are often not talked about or are talked about coyly, which is not surprising for a topic that is simultaneously related to sexuality and disease or even death. But it is ignorance that allows STDs to remain a scourge of humanity. In recent years, even in industrialized nations, there has been a resurgence in disease rates – and this despite all the education and safer sex campaigns in the wake of the HIV epidemics.
Of microbes and people
STDs, or sexually transmitted diseases, refer to infections that are transmitted primarily through sexual contact and primarily affect the reproductive organs. Since an infection does not necessarily lead to a clinical picture, the term sexually transmitted infection (STI) is also commonly used. Previously, only the following “classic STIs” were included in the term:
- Gonorrhea,
- Syphilis (Lues),
- Soft chancre (ulcus molle)
- Venereal lymphadenitis (lymphogranuloma venereum
Today one grasps under it also:
- Viral infections such as genital herpes, warts and cytomegaly.
- Inflammation caused by bacteria, especially of the genitourinary tract (for example, infections caused by chlamydia).
- Mycoplasma
- Calymmatobacterium granulomatis (Gardnerella vaginalis).
- Protozoan-borne diseases (trichomoniasis), (giardiasis and amebiosis [especially in homosexuals]).
- Fungal diseases (thrush)
- Diseases transmitted by parasites (scabies, crabs).
- Hepatitis A and B
- Cytomegaly
- Mononucleosis
- HIV / AIDS
The last three of the above diseases are included, even if they are not transmitted only through sexual intercourse and do not primarily affect the sexual organs.
Survival in warm and humid environments.
Even though such viruses, bacteria, mites and other microbes sometimes cause very different symptoms, what they have in common is that they feel particularly comfortable in a warm, moist environment. That is why they make their home in the mucous membranes of the genitals, mouth and rectum. Outside these favorite places, on the other hand, they have no chance of surviving for long. So if they want to travel, they have to wait for the opportunity to come into contact with other mucous membranes. Towels, toilet lids, underwear, doorknobs or bedding, on the other hand, are their downfall after a very short time.
Travel fever and hangover
One reason for the resurgence of the diseases is certainly the population’s love of travel in Germany. Long-distance travel is en vogue – and associated with increased health risks. At the end of the last millennium, Germans took 44.5 million vacation trips, about 10 percent of which were to subtropical and tropical regions. In 2015, the figure was already 69.1 million vacation trips. But the number of work-related long-distance trips has also risen sharply. There is no mistaking the danger of bringing back more than a brief bout of vomiting diarrhea as a travel souvenir. While it is estimated that only about 0.2 to 0.3 percent of long-distance travelers come back with STD or hepatitis B, that still equates to 10,000 people per year.
Sexual contacts abroad
Meaningful statistics on pleasure and frustration while traveling are naturally rather scarce. According to a survey by the “Studienkreis für Tourismus” (Study Group for Tourism), the federal government’s health report mentioned about 8.5 percent of travelers who had sexual contacts with people they met on the trip or in the vacation destination. Extrapolated, this would correspond to about 2.2 million Germans per year!In another survey of heterosexual men, 23 percent said they had never used condoms during such sexual contacts, and 20 percent had not used condoms regularly. If these figures are taken into account, the risk of infection with an STI does not seem insignificant. Older “sex tourists” in particular, who already travel with the intention of having sexual contacts primarily with younger local women, are happy to forgo this protection. In the case of acute hepatitis B, for example, it is estimated that up to 50,000 new infections occur each year, which are also transmitted through sexual contact. This happens in about a quarter of cases when traveling abroad.
Hard facts and dark numbers
Until 2001, physicians were required to report infections with gonorrhea, syphilis, ulcus molle, and lymphogranuloma venerum anonymously, without disclosing patient information. Currently, non-nominal reporting is only done through the laboratory, and is mandatory when HIV, syphilis, and hepatitis pathogens are detected. This makes it more difficult to obtain reliable data on the spread of STDs. Doctors are now calling for gonorrhea to be made a notifiable STD again and for chlamydia to be declared one as well, since these two diseases have a considerable number of new cases. It is estimated that 80,000 people in Germany alone contracted chlamydia and 10,000 people contracted gonorrhea in 2011. The number of new cases of notifiable STDs each year has more than quadrupled since 2001, amounting to nearly 7,000 in 2015, and it is estimated that the number of unreported cases is many times higher than the official number. Per 100,000 inhabitants, there were officially eight people with a reportable STD in 2015. Again, the actual number will be much higher than the official figures. In the 1990s, the Robert Koch Institute estimated that the number of unreported cases of gonorrhea was 85 percent.
Irresponsibility is a problem
It is also not uncommon for affected individuals to have multiple infections at the same time or to have already had one or more STDs. Even taking into account the uncertainties inherent in such estimates, it is clear that sexually transmitted diseases are a serious problem not only in the developing world. The continuing taboo on the subject and stigmatization of those affected make it difficult to stop the spread. The threat of AIDS has lost its acute horror thanks to more effective therapies. As a result, increasing carelessness in sexual intercourse with strangers and the abandonment of condoms are also contributing to the fact that STDs are on the rise again. The pathogens are probably also being transmitted more and more frequently during unprotected oral sex – a practice whose risk is usually underestimated. Young people in particular often lack information about the causes and symptoms of STIs, which makes them particularly susceptible to infections, partly due to their promiscuity. And because of their ignorance or out of fear and shame, they do not seek treatment and carry the disease further. To make matters worse, inadequate medical care in some parts of the world also encourages the spread of new, more resistant pathogens.
To the point
- Dangerous: STDs are still important today and endanger health, especially if they are detected and treated too late.
- Quiet: STDs can occur without symptoms and thus spread unnoticed.
- Multiple: Different STDs can also occur simultaneously.
- Recurrent: STDs can get again and again.
The safest way to protect yourself from infection is to use condoms, preferably in combination with a sperm-killing ointment.
