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Sexual Disease Screening

Sexual disease screening: Chlamydia, HPV and HIV

Intro

Screening for sexually transmitted infections (STIs) can help prevent the spread of infections. Many STIs are asymptomatic and a person may be a carrier for the virus or bacteria but not know it. It is therefore recommended that all sexually active individuals including adolescents, young adults and senior citizens be tested for STIs periodically especially if they have engaged in high-risk behavior. High-risk sexual behavior includes unprotected sexual intercourse, having multiple sexual partners, having sex with a person known to be injecting drugs intravenously and having sex with a prostitute. Common STIs include chlamydia, human immunodeficiency virus (HIV) and human papilloma virus (HPV) infections.

Chlamydia: is an infection caused by the bacteria Chlamydia trachomatis, spread via sexual contact. It is often asymptomatic and therefore goes untreated. Untreated chlamydia can lasts for years and results in pelvic inflammatory disease in women and epididymitis in men. Both conditions may affect the fertility of infected men and women. Therefore even if an individual does not notice typical chlamydia symtptoms such as abnormal vaginal or penile discharge, painful urination, itching and swelling in the genital area, it is recommended that they get tested yearly if the following conditions apply to them:

  1. They are homosexual males
  2. They are sexually active women under the age of 25
  3. They have HIV or other STIs
  4. They are commercial sex workers
  5. The became sexually active at a young age

Testing for chlamydia is done by taking cell samples from the cervix in women and the penis in men. Urine testing may also be done. Laboratory tests are then done to identify the bacteria. These tests include nucleic acid amplification tests such as polymerase chain reaction (PCR), DNA probe tests, enzyme linked immunosorbent assay (ELISA) and bacterial culture identification.

HPV: is a virus transmitted through sexual contact. There are many types of HPV viruses and some can cause genital warts in both men and woman. Most sexually active individuals are thought to be infected with HPV in their lifetime. However in many cases, the infection does not show symptoms and the virus leaves the body in a few years. In other cases, the virus can lie dormant in women, leading to abnormal changes in cervical cells and eventually cervical cancer. HPV can also lead to cancers of the vagina, penis, anus, mouth and throat. Screening is only available for women and involves a pap smear test and the HPV test. In the pap test, a cervical swab collects cells from the cervix, which are then examined under a microscope. The detection of abnormal cervical cells may result in the doctor recommending HPV testing.  In general pap tests are recommended for women between the ages of 25 to 60.                                                                                                                                                                       HPV testing is done if the pap test is abnormal or in women over 30 years of age. It detects the presence of certain types of HPV that can cause cervical cancer. Women who have HPV may not necessarily get cancer but early detection of the virus through screening can help one decide on detection and treatment options in the future.

HIV: is the virus that causes acquired immunodeficiency syndrome (AIDS). AIDS  has no cure and is the complete breakdown of the body’s immune system, which leads to an infected person becoming prone to opportunistic infections such as pneumonia, candidiasis and lymphomas. However, the progression from HIV infection to AIDS may take years during which time there may be few or no symptoms. It is therefore imperative that one is screened for the virus so that if detected, treatment can begin. Physicians recommend that HIV screening be done as part of routine health care check ups, at least once for individuals between the ages of 15 to 60. High-risk individuals should ideally get tested annually. The following individuals may be considered high-risk for HIV infection

  1. Sexually active gay and bisexual men
  2. Individuals who have had unprotected sexual intercourse
  3. Individuals who may have used needles for intravenous drug use or those who may have had sex with intravenous drug users
  4. Commercial sex workers
  5. Individuals who have other STIs such as chlamydia, gonorrhea, hepatitis or herpes
  6. Individuals who have multiple sexual partners

Pregnant women are also required to be screened for HIV as part of their routine prenatal health care. This is done so as to detect the virus, if present, and decide on treatment options for the mother and child.HIV tests usually involve using blood samples to detect antibodies toward the virus. Sometimes testing may be done on saliva or urine samples. Antibody tests include ELISA and rapid antibody tests. Nucleic acid amplification tests such as PCRs may also be used to diagnose HIV infection.

Treatment

Even if one gets a negative result while screening for STIs, it is recommended that high-risk individuals get tested annually. A positive result will require in most cases further confirmatory testing, followed by appropriate treatment as recommended by one’s doctor.