Spread of STI
STIs or sexually transmitted infections can be spread in several ways.

• STI is usually spread through sex because the bacteria or viruses travel in semen, vaginal fluids, and blood.
• Saliva (or spit) can sometimes spread STI if you have a tiny cut in or around your mouth. Infected blood on needles and syringes can spread STI.
• Infected women who are pregnant can pass an STI to their babies during pregnancy and at childbirth.
• Except for hepatitis B, there are no vaccinations to prevent STI. If you get an STI once, you can get it again.

And, you can have more than one STI at a time. Many STI’s are easily treated, but all can be dangerous if ignored. For some STI, like genital warts, genital herpes or HIV, there is no cure today.

Myth
“You can’t get an infection or get pregnant the first time you have sex or if the guy doesn’t ‘Come’ inside the woman”.

Fact
Yes, you can. And sex doesn’t have to be full intercourse: you can get an STI just by having really close genital contact with an infected partner. Infection can be spread by body fluids or by oral sex. Protect yourself and your partner by using a latex condom for any kind of sexual activity.

The most commonly found sexually transmitted infections in India is:
Gonorrhea
Gonorrhea (or “Clap”) is an infectious sexually transmitted infection that chiefly affects the mucous membrane of the urogenital tract, the rectum, and occasionally the eyes. The disease is caused by gonococci and belongs to the genera of Neisseria. Discharges from the involved mucous membranes are the source of infection and the bacteria are transmitted by direct contact, usually sexual or during passage of a newborn through the birth canal.

Causes, Incidence, and Risk Factors of Gonorrhea
This infection occurs in people who have been infected with gonorrhea. It affects women more frequently than men (4:1) and its highest incidence is among sexually active adolescent girls. There is also increased risk during menstruation and pregnancy. Two forms of arthritis exist, one with skin rashes and multiple joint involvement but no demonstrable gonococci in the joint fluid; and a second, less common form where disseminated gonococcemia leads to infection of a single joint (monoarticular) and joint fluid cultures are positive.

Single joint arthritis follows generalized spread (dissemination) of the gonococcal infection. Dissemination is associated with symptoms of fever, chills, multiple joint aches (arthralgia) and rashes (1mm–2cm red macules). This episode may end as a single joint becomes infected. The most commonly involved joints are the knee, wrist, and ankle.

In Male
Usually, suffer’s inflammation of the urethra with pus and painful urination. Fibrosis sometimes occurs in an advanced stage, causing narrowing of the urethra. There also may be involvement of the epididymis and prostate gland.

In Female
Infection may occur in the urethra, vagina, and cervix, and there may be a discharge of pus. However, infected females often harbor the disease without any symptoms until it has progressed to a more advanced stage. If the uterine (Fallopian) tubes become involved, pelvic inflammation may follow. Peritonitis, or inflammation of the peritoneum, is a very serious disorder. The infection should be treated and controlled immediately because, if neglected, sterility or death may result. Although antibiotics have greatly reduced the mortality rate of acute peritonitis, it is estimated that between 50,000 and 80,000 women are made sterile by gonorrhea every year as a result of scar tissue formation that closes the uterine tubes. If the bacteria are transmitted to the eyes of the newborn in the birth canal, blindness can result.

Prevention of Gonorrhea
Prevention consists of following safer sexual practices. Monogamous sexual relations with a known disease–free partner are considered the ideal means of prevention. The use of condoms provides the best protection against gonorrhea and other sexually–transmitted diseases. Treatment of all sexual partners of a known infected person is essential to prevent further spread or re–infection.

Symptoms of Gonorrhea
The Common Symptoms are:

• Migrating joint pain for 1 to 4 days (polyarthralgia).
• Single joint pain.
• Fever.
• Skin rash or lesion.
• Vaginal or urethral discharge.
• Pain or burning on urination.
• Lower abdominal pain.

Signs and Tests of Gonorrhea
The Doctor may advice one or more of the following tests:

• Positive cervical gram stain (positive for gonococci).
• Urethral culture for gonorrhea in men.
• Cervical culture for gonorrhea in women.
• Throat culture for gonorrhea.
• Joint fluid gram stain.
• Synovial fluid culture for gonorrhea (culture of joint aspirate).

Treatment of Gonorrhea
Abstinence from coitus until the infection is eradicated. Patients are advised bed–rest and analgesics. Various antibiotics are prescribed.
Medication Include:

• Injections.
  Ceftriaxone 125 mg IM (injected into a muscle).
  Spectinomycin 2 grams IM (injected into a muscle).
• Oral (by mouth) one–time dose.
  Cefixime 400 mg.
  Ciprofloxacin 500 mg.
• Ofloxacin 400 mg.
  Cefuroxime Axotal 1 gram.
  Cefpodoxime proxetil 200 mg.
  Enoxacin 400 mg.
• Oral (by mouth) multiple dose.
  Erythromycin 500 mg, four times per day, for one week.

A follow–up visit 7 days after treatment to recheck cultures and confirm the cure of infection is important.

Complications
If untreated, Gonorrhea may lead to: persistent discomfort, other gonorrhea complications, such as disseminated gonorrhea (spread throughout the body). Hence, immediate diagnosis and treatment of gonorrhea is essential.