Sadly, despite increased awareness, sexually transmitted diseases continue to spread at an alarming rate. Wendy Champagne outlines the numerous diseases that await sexually active people who continue to take risks.

You see them on railway stations, in public toilet blocks, at international airports and hotels - condoms - big, small, coloured, textured, scented or decorated, they are the most widely available and accepted sex tool in the world.

They are also the most valuable, because without condoms there would be no significant global weapon against the rapid spread of sexually transmitted diseases, STDs.

STDs: What are they?

Any disease transmitted though oral, anal or vaginal sex.

• HIV/AIDS
• Hepatitus A,B & C
• Syphillis
• Gonorrhea
• Chlamydia
• Genital Herpes
• Human Papillomavirus (HPV) leading to Genital Warts
• Trichomoniasis and Bacterial Vaginosis

Who is at risk?

Anyone who has sex outside a long-established, monogamous relationship is vulnerable to STDs. And the more sexual partners you come in contact with, the greater your chances of contracting one.

Groups considered to be at the greatest risk in Australia are:

• Homosexually active men and the sexual partners of bisexual men Injecting drug-users and their sexual partners
• Young sexually active heterosexual adults (men and women)
• Sex workers
• Prisoners
• Overseas travellers
• Recent immigrants

HIV/AIDS is an incurable STD. Over the past twenty years the Western world has successfully taken on the challenge of the HIV/AIDS epidemic, heightening awareness of the disease and improving and extending the lives of those inflicted.

But many sexual health practitioners are disturbed at the alarming rise in the other, more common STDs and the general lack of knowledge about them in the community.

Concerns voiced in a policy paper released in 1999 by the Australian College of Sexual Health Physicians, highlight the need for renewed focus on data collection of the less high profile STDs.

"Whenever policymakers single out one communicable disease for special attention (referring to HIV/AIDS), they run the risk of others being overshadowed and neglected," says the report.

About STDs

Statistically, if every American who had an STD moved to Canada, it would more than double the population of its northern neighbour. About 40 million Americans have sexually transmitted diseases and despite Australia's poorly-resourced surveillance of STD's, sexual health practitioners believe its statistics are just as disconcerting.

Currently, although Australia is enjoying marked improvement in gonorrhea, syphilis and chlamydia in the metropolitan centres, by contrast, rural Aboriginal centres are experiencing extremely high incidence rates among their populations. Gonorrhea amongst homosexually active men looks to be on the rise, according to details released recently in Victoria.

Hepatitus B is the most costly of all the STDs in Australia, claiming 1200 lives and year, and 3000 new infections reported annually, despite the fact that a safe and effective vaccine has been on the market for the last fifteen years.

Most people are unaware that chlamydia is one of the most common STDs, even fewer know it affects both men and women, and still less know that undiagnosed and untreated it is the major cause of pelvic inflammatory disease (PID) in women - a serious complication that blocks the fallopian tubes and may cause infertility.

It's estimated that as many as twenty percent of sexually active men and women in Australia acquire one form or another of genital herpes. And to make matters worse, the majority of these people don't know they have it. Herpes simplex 2 is a lifelong disease, everybody is infectious, and the men and women who do develop the genital sores associated with the virus, are at a greater risk of contracting HIV/AIDS through the open blisters.

Genital warts are probably most prevalent of all genital infections. Caused by the human papillomavirus (HPV), this STD is difficult to treat and has stubborn rates of recurrence. In Australia today there are more deaths from HPV-related cervical cancer than from HIV/AIDS.

At one point in an actively sexual life almost every woman contracts a vaginal infection or irritation. Trichomoniasis and bacterial vaginosis may see harmless enough, but they are not. Both these STDs are important causes in low fertility rates, pre-term deliveries and low birth weights.

Avoiding STDs

Abstinence is the most effective measure against sexually transmitted diseases. But if you can't just "say no", then "safe sex" is the next best thing. Use condoms. And if you have any suspicion that you have an STD, don't hesitate! Go to your doctor, call the STD hotline, or go make an appointment with your nearest sexual health clinic.

References:

State Government of Victoria, Public Health Division

Sydney Sexual Health Centre. Freecall: 1 800 451 624

A Strategic Approach: Developing a National Communicable Diseases Strategy for Sexual Health, Australian College of Sexual Health Physicians March 1999.