Sexually transmitted infections (STIs) are a public health problem, especially in developing countries, such as Romania. The prevalence of STIs varies from country to country, as well as between different population groups within the same country. In this sense, Dr. Cristina Cornoiu, family medicine specialist at the Family Planning Office of the Târgu Jiu County Emergency Hospital, has produced an informative material.
Chlamydia is the most commonly reported STI in Europe, gonorrhea is common in men and young people under the age of 25, and syphilis has the most cases in males.
“Within the Family Planning Cabinet, actions are being taken to prevent STIs and to educate the population about the risks associated with these diseases. A representative case consulted at the office is that of a teenage girl who presented with a very painful acute vulvovaginitis, accompanied by fever and altered general condition. The vulvo-vaginal mucosa was red, edematous, with very numerous vesiculo-erosive lesions. From the anamnesis we note the recent onset of sexual life, with a partner who had already had a considerable number of sexual partners and who did not approve of condom use. Since the anamnesis and the clinical picture pointed to the diagnosis of genital herpes, the patient was referred to the dermatovenerology office for further investigations (infection with one of the two herpes viruses does not prevent infection with the other; often several STIs can be diagnosed simultaneously at the same patient and are sent to the package) and treatment. The diagnosis was confirmed, the patient received treatment and a set of tests was recommended to detect the most common STIs. She was also advised to contact her partner, explain the diagnosis and insist that he be investigated (one of the basic principles of STI control is partner treatment). The goals of partner management are: interrupting the STI transmission chain, preventing reinfection of the source patient (the index case), identifying and treating people who have been infected, and promoting responsible sexual behavior in people at risk of infection. The patient decided to move her domicile to Spain, that’s why the follow-up of the case had to be interrupted”, said Dr. Cristina Cornoiu.
At the level of the Family Planning Cabinet, prenuptial medical certificates are issued to couples who wish to officiate a civil wedding. For the issuance of these certificates, partners must prove their state of health, performing a series of investigations and medical consultations. These include blood tests for syphilis and HIV infection.
“We can encounter, for example, the following situation: a young man can present a positive semi-quantitative carbon RPR (suggestive for the diagnosis of syphilis). He is referred to the dermato-venerology office for the initiation of treatment and the issuance of a certificate attesting to this. Mandatory, the partner is informed and declares in writing that she has become aware of the diagnosis and the initiation of treatment in the case of the partner. The young woman has the freedom, knowingly, to choose either to continue the steps towards marriage, or to give up. The condom is the only method of contraception that protects against the transmission of STIs. Current and consistent use of latex condoms reduces the risk of STI transmission. However, condoms cannot provide absolute protection against all STIs. The most reliable way to avoid STI transmission is abstinence or a monogamous relationship with an uninfected partner. In reality, many infected people are unaware that they are infected because STIs are often asymptomatic. Condoms may not cover all infected areas or areas that may become infected. Condoms most likely offer superior protection against STIs that are transmitted only through genital fluids (STIs such as gonorrhea, chlamydia, trichomoniasis, and HIV infection) and less against infections that are primarily transmitted by skin-to-skin contact, which can or does not infect the areas covered by a condom (STIs such as genital herpes, HPV infection, syphilis). If the patient has a latex allergy, synthetic polyurethane condoms can be used. It is important to point out that polyurethane condoms have higher breakage rates than latex condoms,” added the doctor.
