Sexually Transmitted Diseases

The likelihood of contracting a sexually transmitted disease (STD) is very high today when one engages in illicit sex. This fact must be seriously considered when a partner or one preparing for marriage has engaged in sexual sin, especially in its effect on the spouse or sexual partner. Fear rests in the hearts of many, especially women over this major current issue.

Each succeeding disease seems worse that the last.

-It the past it was mainly Syphilis and Gonorrhoea.
-The Herpes virus began terrorising people in 1976.
-Chlamydia began making headlines in the early 80s and is now one of the most common STD.
-Then came the HPV virus causing genital warts, which is now spreading faster than the others.
Finally, the vicious plague of AIDS.

This is the result of the sexual revolution which began in the 50s. How true the scriptural statements are, "The way of transgressors is hard" (Proverbs 13:15) and, "There is no peace, says the Lord, for the wicked" (Isaiah 48:22). The trouble is, though, many innocent persons become unjustly infected, such as a virgin who marries an infected husband, or an innocent wife who becomes infected from an unfaithful husband.

It is obvious therefore that infection with STD or possible infection with STD and the fear associated with it, with both the offender and his spouse, has to be considered in the healing process.

With the spread of AIDS and other STDs, even secular society is reaching the conclusion that sexual promiscuity can have devastating results. Public Health officials are at last observing that the best prevention against these diseases is maintaining one partner for a lifetime - only confirming that the instruction God has given us in His eternal Word is the most practical way of conducting our lives.

In recent years sexually transmitted diseases have been on the mind of nearly every sexually active person. Many worry about the possibility of acquiring Acquired Immunity Deficiency Syndrome (AIDS), a fatal disease which is having more impact on the country's sexual practices that all the lectures on morality ever did. Those engaging in promiscuous sex and sex addicts recognise AIDS as perhaps the most lethal complication to their illness.

Joe McIlhaney, Christian gynaecologist and author, without desiring to be an alarmist, gives some startling statistics about sexually transmitted diseases.

- Except for the common cold and flu, STDs are the most common diseases in the USA.

- The human tragedy of STD is terrible, and costs the taxpayer over two billion dollars a year.

- It is estimated that one in four Americans of reproductive age will contract a STD in his or her lifetime.

- Sexual intercourse by teenagers is alarmingly high and is constantly increasing and date rape is becoming a major issue (the younger a woman is when she begins sexual activity and the more partners she has, the more likely she is to develop pre-cancerous changes in the cervix and actual cervical cancer).

- STD is a major cause of sterility (Chlamydia, one of the most rapidly increasing STDs, affecting up to 40 percent of the population in some locations in USA, causes sterility in 25 percent of cases with its first infection, 50 percent with the second infection and 75 percent with the third infection. Over 75 percent of both men and women had no symptoms of Chlamydia infection but could readily pass it on to others);

- At least 30 percent of single sexually active Americans have been infected with Herpes (caused by Herpes Simplex II virus), and can pass it on to their partners.

- About 40 percent of single sexually active Americans have been infected with HPV, the human papilloma virus, which causes venereal warts, pre-cancerous changes and cancer to the vulva, vagina and cervix, and cancer of the penis in men (this is the most common STD with more than 90 percent of abnormal pap smears caused by the virus).

- Gonorrhoea is increasing at an alarming rate, and along with Chlamydia, it causes chronic pelvic inflammatory disease (PID), the second most common cause of hospital admission for women during the reproductive age of life (second only to childbirth), and a major cause of sterility.

- Syphilis is rapidly increasing - currently with 16 out of every 100,000 American infected it is the highest it has been since 1950.

- AIDS (caused by HIV virus), the deadly and frightening STD ushered in during the late 80s, is a thousand more times more elusive and difficult to deal with than gonorrhoea or syphilis. There may never be a cure for it (most authorities believe that a vaccine to prevent it is years away).

- Eight percent of single men have had five or more sexual partners in the past year; 47 percent of males tell their dates that they had fewer sexual encounters than they actually did; 23 percent said they would not tell a partner if they were currently involved with somebody else; most would not tell their partner if they knew they had STD.

- There is no known cure for any viral STD, including herpes, HPV, AIDS and Hepatitis.

- A high percentage of unmarried men who have had intercourse with another partner will have a STD they can pass onto others.

- When having sex with a person, you are having sex with all previous partners as far as STD are concerned.

- Without medical data, you cannot know if your sex partner, or the one you plan to have intercourse with, has a STD.

- Condoms are not as safe as many think (10-20 percent of women who use condoms for contraception, become pregnant within a year; and many others refuse or don't bother to use them).

-Marriage is not always the answer, with the high incidence of adultery.

The dramatic rise in the incidence of STDs through unsafe sex is listed as one of the top ten health problems of today. It is estimated that some 3 million teenagers in America will get a STD in one year. The safe-sex message (abstinence outside of marriage) clearly isn't getting across to most Americans.

God says, You must not commit adultery. The purpose of this, and the other nine commandments is often misinterpreted. Some say that God is trying to curtail our freedom and pleasure. But the Commandments are for our own good. History has proven that infractions of God's directives have disastrous results. Nowhere is this more evident than in the sexual realm. God also tells us, There is a way that seems right to a man, but in the end it leads to death (Proverbs 16:25). These and many other scriptures give us perfect advice about sex. Marriages are not perfect, but it is clear that the only safe sex is within the marriage relationship.

Acquired Immunity Deficiency Syndrome (AIDS)

AIDS, the dreaded sexually transmitted disease introduced during the late 80s, is receiving more attention than cancer. It is a major threat to society and one of the most serious health problems that has ever faced the world. AIDS is primarily spread by homosexual practices and it has become the major fear of the homosexual. AIDS is the now the leading cause of death in young men in USA, and has spread extensively in Africa, India, Thailand, and now rapidly through other parts of Asia.

AIDS is a viral infection (Human Immunodeficiency Virus - HIV) in which the normal body defences against infection are so weakened that the infected person cannot fight off other infections. This results in some forms of pneumonia and cancer that are fatal. While some drugs (such as AZT) help to suppress the viral activity, they are not a cure for the disease.

Many are HIV positive, which means they have been infected with the virus, which do not yet have AIDS. The potential for AIDS is there. Such will always be infected and contagious. The term AIDS is not applicable until the silent latent period has passed. A person who is HIV-positive may feel perfectly well and be thoroughly unaware of his infection.

To be transmissible, the AIDS virus needs the warmth and moist surfaces available in intimate contact or the commingling of blood. AIDS is spreading alarmingly, especially among teenagers and college students. Just as many women are HIV positive as are men. There is no safe sex when one partner has the AIDS virus.

The four main risk groups are recognised as.

- Homosexual and bisexual men involved in sexual acts (the major risk group). - Intravenous drug users.
- Those who have received infected blood or blood products before the transfusion services were able to test for antibodies and refuse donors who had been exposed at risk, and sexual partners of any of the above (this will potentially include all prostitutes and casual sex partners.
- It can also be passed from mother to baby in the uterus during birth or possibly in breast milk.
- It is now known that HIV positive doctors and dentists can transmit the disease.

While the incidence of AIDS is high among homosexuals, it is now known to be quite high in the heterosexual relationship. No one is immune who practices sex outside of marriage.

Therapy for those with AIDS (and their families) brings in an additional dimension to the treatment of sexual immorality and addiction. A good deal has been written about this, and it is considered to be outside the scope of this study.

Sexually Transmitted Diseases

Sexually transmitted diseases have been troubling human beings for thousands of years, for example in the times of the New Testament genital warts were known as figs. It is likely that syphilis was a disease that arrived from the New World perhaps either with Columbus or later with the Spaniards visiting South America. Herpes of the genitals was well known in the French Court in the time of the King Louis,' as it was called - papillon l'amour. Gradually the number of these diseases has been increasing until today there are approximately twenty important pathogens including bacteria viruses protozoa and ectoparasites. All can be transmitted by either sexual intercourse or very close intimate contact. .

Human immunodeficiency virus infection appeared in the west in the mid to late 1970s probably brought back by Cuban troops to Havana after service in Angola. The disease is easily transmitted by anal sex. It is estimated that at least two million persons currently living in Australia today are infected with genital herpes. Whilst the incidence of chlamydial infections appears to have decreased in the main capital cities, this pathogen as well as gonorrhoea and syphilis are very common in those parts of Australia where Aboriginal people live.

Unfortunately, there can be no let-up in surveillance or in control programs as these diseases are always liable to reassert themselves and do. In addition, drug resistance is an ongoing problem particularly with gonorrhoea, which has the biological make-up allowing it to find ways of blocking the action of most of the drugs that have been used against it. We need to realise that God has set specific rules for our behaviour that we ignore at our peril. For example, it has even been suggested that if it were possible to ensure that no person on earth changed partners for six weeks then gonorrhoea would disappear.

Currently the emphasis in public health is being placed on educational, behavioural and therapeutic methods to try and control the spread of these diseases by changing sexual practices and using "safe- sex" and encouraging people to seek early and proper treatment. From time to time there has been some improvement as after the onset of the AIDS epidemic when there was a lot of scare tactics promoted in the media and enormous health promotion activities, for a few years the number of reported STDS reduced in the capital cities of Australia. However, this has not been maintained and figures are again increasing.

Public health departments are now beginning to realise that much more is needed to bring about these changes than merely provision of education knowledge and handy treatment clinics.

It is recognised that the following factors have to occur as well:

1. Individual's perception of risk must be addressed.
2. Self-knowledge and understanding must increase.
3. Self-assertiveness must be based on internalised basic rules for living!
4. Peer pressure has to be countered by both raising self-esteem and self worth.
5. Support persons and groups are needed to reinforce life ideals.
6. Role models are needed!

Public health officials are now examining how to promote the following:

1. Reduction in the number of sexual partners; preferably to one!
2. Increasing the age of the first sexual encounter; ie. delaying or postponing sexual intercourse until adulthood. (Both of these would be accomplished by the Christian marriage commitment).

Some important points.

1. Biologically different STDS have different degrees of infectivity. (Eg. Hepatitis B is thousands of times more infective than HIV).
2. STDs also have different modes of transmission. (Eg. syphilis and gonorrhoea).
3. Behaviourally different sexual acts carry different degrees of risk of infection. (Eg. vaginal sex is less risky than anal sex for the transmission of HIV.
4. Women are biologically more susceptible to infection than men and are more likely to be completely unaware of any infection.
5. Condoms impede the transmission of some STDS but warts herpes and hepatitis can still be transmitted.
6. Women's intentions to ensure that men use condoms are affected by fear of force, and/or abandonment.
7. Early detection and treatment can reduce STD sequelae such as cervical cancer, PID, and ectopic pregnancy.

STDS and the Modern Life Style

Counsellors should understand that persons living the modern sexual life style of non-committed serial monogamy sexually transmitted diseases pose a major problem. Some of these diseases once contracted are for life such as herpes genitalis where treatment is only suppressive and the partner is almost certain to contract the disease in the end. Other diseases such as wart virus infection are very difficult to treat and can be difficult to diagnose. HPV can lead to cancer of the penis or of the cervix. Women once infected have to have pap smears yearly there after and their partners are always liable to transmit to them again despite the best measures taken. Other diseases such as chlamydia can cause PID and may lead to infertility. Therefore, the life style is hazardous, and some patients are never really happy and content.

Where one partner in a cohabitating couple contract one of these diseases especially warts or herpes there is often guilt and recriminations. Break up is often the next step. Those infected are then in a quandary, not knowing whether they will be able to develop another relationship or whether or not to tell any future partner that they are infected! This becomes a major problem because the current social culture requires that sexual intercourse take place early in the friendship generally before any deep relationship or commitment is even considered.

Some Important Sexually Transmitted Diseases

Syphilis

Syphilis is a chronic disease that can be transmitted in a number of ways, from a sore on the mouth anus penis or breast to lips or genitals, or by blood or serum or from mother to foetus. It is often seen first as a small painless sore that disappears after nine days or so. Then three months later a pale pink rash develops on the body, that is also very infectious and there may be warty lesions around the genitals anus and breast. After a few weeks this also disappears and the patient may then seem ok but then a few years later troubles can occur in virtually any body system - especially the brain, hearts, large blood vessels, bones, liver and so on. This disease is uncommon today in Australian capital cities but twenty-five years ago was very common especially in the gay community. It is seen today amongst Aboriginal Australians in the outback. If found, early it is treated with penicillin but large doses are required.

Gonorrhoea

Gonorrhoea has been known as the clap and was very common in the naval personnel in the days of Nelson at Trafalgar when officers carried wooden flat boxes containing varying sized probes of steel called" bougies "to insert into their urethras to break down strictures and allow them the adequately pass urine. It has followed armies from time immemorial and was common during both world wars in the twentieth century. It became common again during the so-called sexual revolution in the 1960's. After the 1970's and 1980's, this disease started to reduce in incidence in all western countries.

It is transmitted by sexual intercourse and in the female the organism affects the cervix and then spreads up in to the fallopian tubes where it severely scars and blocks the fallopian tubes leading to infertility and ectopic pregnancy. It used to be a major cause of blindness in babies - as the infant passed through the infected cervix the eyes would be infected as would the throat and stomach. It was for this reason that early in the twentieth century silver nitrate drops were routinely instilled into babies' eyes as a preventive. This practice has now stopped.

In the male gonorrhoea, affects to urethral lining and causes a dirty yellow green discharge. Those infected say that when they pass urine it feels as if they are pissing razor blades. Drug resistance developing against gonorrhoea with most drugs has made treatment of this condition a continually difficult and changing matter. The highest rates of infection are seen in young people

Chlamydia

The chlamydia organism has also probably been around for generations as men were said to have "gleet" in past years when the gonorrhoea organism could not be found under the microscope. The disease is mostly seen in young people in the late teens and early twenties. In the male, the urethral discharge is usually clear and mucoid and only causes slight discomfort. The organism however causes much trouble in females as it affects the fallopian tubes gradually causing scarring and leading to pelvic inflammatory disease (PID) and some women only notice a slight feeling of being unwell for several months. Unfortunately, in a large proportion of women, the disease is completely clinically silent and goes unrecognised and untreated and as the bacteria remain infectious, it is easily transmitted to sexual partners. Sadly, the outcome of this that many women gradually develop increasing problems with fertility until complete infertility occurs.

Treatment can be effective if started early but PID once developed is very difficult to treat. (Non-Gonococcal Urethritis was the name given to chlamydia-like infections before the technology was available to diagnose this infection.)

Human Wart Virus Infection

This is a condition present in epidemic proportions in our society today the warts can occur on the genitals or around the anus or even in the mouth and throat. Some varieties, when they occur on the genitals, are liable to initiate cancer. This is especially seen on the cervix or the bases of the penis with certain of the HPV types. As well, anal cancer is occasionally seen and is slowly increasing especially in homosexual men and those who are HIV positive. Warts can sometimes be transmitted during birth to the infants and appear in the throat and larynx in children and although uncommon it is very significant because patients are primarily children who may then require multiple surgeries. Subsequent laryngeal cancer is also occurs.

Treatment of all wart virus infection especially genital and anal warts is difficult and protracted. Cancer of the cervix is insidious and a major health problem not only worldwide but also in our society.

Herpes Genitalis

This infection is also very common in our society and where one person in a relationship has the condition, the other will become infected within a decade despite all efforts. Recurrent genital sores that make sexual intimacy difficult trouble and humiliate those infected. The problem of almost continuous asymptomatic viral shedding makes the question of trans mission an ongoing difficulty to both those infected and their partners. The disease can be transmitted to the foetus passing through the birth canal and although rare, neonatal herpes is a devastating problem to the child and the parents. Oral sex is a potent way to transmit the disease and the author has seen couples presenting during their honeymoon with just this problem after engaging in oral sex. Nevertheless, this disease is mainly a social and emotional problem rather than a major physical one but it can be devastating especially in those persons who do not have the ability to make permanent relationships. Thus for those living the current lifestyle of serial monogamy it can be a catastrophe because many have lost the ability to court another person.

Treatment of those troubled with recurrent sores is possible with daily drug treatment, which suppresses the symptoms but does not cure the condition. Complete eradication is impossible at present.

Hepatitis B

Hepatitis B is a highly infectious condition that can be transmitted sexually, by close person contact, from mother to the infant at birth, by sharing dirty IV needles and by infected blood products. Dentists and doctors have not only contracted the disease from patients but when infected, they themselves have transmitted the disease to their patients. The writer has seen many patients who contracted the disease from prostitutes even when condoms were in use. Today immunisation for Hepatitis B is readily available and it is the writer's opinion that all people should be immunised. The outcome for those infected with the disease is that some clear the infection some go onto chronic liver disease and some to cancer of the liver. A small proportion are either seriously infectious for the rest of their lives whilst some are only very mildly infectious. Sexual transmission of this disease is promoted by certain factors such as being a female sexual partner of a male who is infectious or being homosexual and having anal sex. Furthermore the greater the number of years of being sexually active with an increasing number of partners increases the risk. The disease is of particular importance to persons who inject drugs.

Human Immunodeficiency Virus Infection

HIV is a chronic viral infection that is lifelong, and seriously affects the immune system.

AIDS is the stage of the disease where serious changes occur such as cancers or major super-infections because damage to the immune system has permitted invasion of the body.

The disease generally lasts between one to twenty years and some people seem to have some ability to fight the disease due either to the virus being a little less damaging to the immune system or where the patient has some slight genetic benefit. The HIV virus constantly changes and mutates and this is making planning therapy and devising a suitable vaccine difficult. The female to male transmission ability is much less "efficient" than male to female and both of these are less than receptive anal intercourse where the risk is extremely high. Use of contaminated needles where needles are shared is also a major method of viral transmission.

Treatment best starts early in the infection to try to prevent the immune system from degenerating.