“Exploring the Significance of STI Screening and Awareness.”

What are STIs?

These diseases are most often transmitted during sexual relations, with or without penetration, most often during unprotected intercourse. They are caused by bacteria, viruses or parasites.

List of major sexually transmitted infections

To date, there are around thirty STIs.

The most frequent are:

• among bacterial STIs: syphilis, gonorrhea, chlamydiosis and mycoplasma infection;
• among viral STIs: hepatitis B, genital herpes, human immunodeficiency virus (HIV) and human papillomavirus (HPV);
• Among parasitic STIs: trichomoniasis.

For exemple :

HIV: one of the best-known STIs

The human immunodeficiency virus (HIV) causes a weakening of the immune system and very often goes unnoticed. Without treatment, sufferers become more vulnerable to illnesses and certain cancers. The disease then progresses to AIDS (acquired immunodeficiency syndrome).

Early detection of HIV infection, in relation to the date of contamination is essential.

It is important both individually and collectively.

It allows:

• to avoid contamination if the treatment is initiated as soon as possible, preferably within the first 4 hours, at the latest within 48 hours, after a risky report (post-exposure treatment to HIV, generally called “emergency treatment” ),
• to provide the infected person with treatment that is all the more effective the earlier it is started, with a life expectancy that is closer to that of the general population,
• reduce the risk of transmitting the virus.

Note that there is a prevention of pre-exposure to HIV (PrEP) for adults at high risk of contamination.

This pre-exposure prophylaxis is a form of prevention that complements the other measures recommended to prevent HIV infection: use of a condom (which protects against the risk of other STIs), regular HIV screening, post-exposure prophylaxis and, in HIV-positive people, antiretroviral treatment.

HIV testing is recommended on a regular basis in some cases;

Are concerned :

• men who have sex with men,
• injection drug users,
• people from areas where HIV infection is common, particularly sub-Saharan Africa and the Caribbean.

Screening is recommended on an ad hoc basis in the following circumstances:

• for a couple planning to have a child or during pregnancy;
• during a first prescription for contraception;
• in the event of a plan to stop using condoms;
• in the event of a request for voluntary termination of pregnancy;
• after a rape;
• while incarcerated;
• after exposure to a risk of HIV contamination (sexual, blood or occupational risk);
• when diagnosing a sexually transmitted infection (STI), hepatitis B or hepatitis C or tuberculosis;
• in the presence of an evocative clinical picture.

In addition, anyone can be screened whenever they wish, regardless of the reason that leads them to this process.

Anyone, without risk of exposure to a risk of contamination, should take an HIV screening test at least once in their life between the ages of 15 and 70.

Chlamydia infections : Among the most common STIs, often unrecognized because it can evolve quietly, without symptoms

THE Chlamydia infections (chlamydia) are often asymptomatic. The contamination goes unnoticed most of the time because there are few symptoms, if any. They can affect both women and men. The treatment of these STIs is very simple and very well tolerated; it relies on antibiotics.

But without symptoms, Chlamydia infections may not be detected and treated, which exposes you to complications.

Possible complications of an untreated Chlamydia infection:

• In women: risk of salpingitis (uterine tube infection), infertility, ectopic pregnancy and damage to the newborn if the mother is infected.
• In men: inflammation of the testicles and epididymides, of the prostate, Fiessinger-Leroy-Reiter syndrome (polyarthritis reactive to a genital infection).

How are STIs transmitted?

During sex

There are many modes of sexual transmission: vaginal or anal penetration is the most common mode, but sometimes simple mucosa-to-mucosal contact may suffice. You can therefore have contracted an STI during sexual intercourse, whether there is penetration or notand regardless of the sex of his partner.

During pregnancy

Some STIs can also be transmitted from mother to child during pregnancy and childbirth:

• la chlamydiose ;
• gonorrhea;
• hepatitis B;
• HIV infection;
• syphilis.

Note that HIV can also be transmitted through breastfeeding.

What are the symptoms of STIs?

Most STIs can be asymptomatic

Most often, STIs are asymptomatic. They do not necessarily have specific symptoms that could encourage them to be screened. They can therefore be transmitted without knowing it and require all the more vigilance.

Precautionary measures:

Condoms protect effectively but not 100%. Indeed, caresses and mouth-sex relations are also opportunities for transmission. Hence the importance of getting tested regularly in case of unprotected sex or in case of multiple partners.

It is recommended to have recourse to screening in the slightest doubt and especially in the event of a risky situation:

• if you have had unprotected sex;
• if you have several sexual partners;
• if you have a new partner regular ;
• if you have ever had an STI.

Signs that should alert

There are some common symptoms of STIs, including:

• inflammation of the genitals (redness of the skin and increase in volume of the scrotum (envelope of the testicles) or the large and small lips of the perineum);
• discharge from the penis or abnormal vaginal discharge (unusual color and/or smell);
• burning while urinating;
• pain during intercourse;
• lesions of the mucous membranes or skin on the genitals;
• lower abdominal pain;
• swelling (lymph nodes) in the groin;
• fever and fatigue.

In the presence of these signs and after a risky behavior, it is recommended to consult a doctor without delay.

Protection and screening:

Ways to prevent STIs

The condom is the most effective means of protection

To protect yourself and your partners, the condom (female or male) remains the best solution. It is advisable to use one for each intercourse, as long as it is not certain that the partner does not have an STI.

But there are exceptions. In two specific situations, the condom does not fully protect:

• papillomavirus infections;
• primary infection and outbreaks of genital herpes because the risk of contamination is too great. In this specific case, it is better to avoid even protected sexual relations.

Screening methods

Several tests can detect STIs:

• medical exam
• bilan sanguin;
• local sample (vaginal smear for example);
• urine analysis.

Screening is possible in:

• analysis laboratories;
• free screening and diagnostic information centers (CEGIDD);
• sexual health centers (formerly family planning and education center: CPEF);
• PMI centers (maternal and child protection)
• certain local associative structures.

Note that the accompaniment by the doctor, the gynecologist or the midwife is important in the care in case of suspicion of STI.

The earlier the detection, the more it is possible to put in place an early treatment. This allows you to benefit from better care with better chances of recovery.

En cas d’IST :

• Follow the prescribed treatment carefully: the treatments most often make it possible to cure and at least to prevent the development of certain infections;
• Protect yourself during your treatment: during your treatment, you are always contaminating! It is therefore preferable not to have sexual intercourse for 7 days following the treatment;
• Talk to your partner about it: so that he gets tested and treated and to avoid any risk of recontamination;
• Get tested regularly.

Vaccines: papillomavirus and hepatitis B

All STIs are not eligible for vaccination except hepatitis B and papillomavirus infections

• Vaccination against hepatitis B is compulsory for infants over 2 months old born after January 1, 2018, for health professionals and students in the medical and paramedical fields. A catch-up can be offered to teenagers under 16 years old.

It is recommended for children and adolescents under 16 who have not yet been vaccinated and for people who are at high risk of contracting the disease: people with risky behavior (multiple sexual partners, intravenous drug users) as well as that people who are incarcerated, homeless, from sub-Saharan Africa, etc.

• Children born to a mother with active hepatitis B receive a vaccine within 24 hours of birth, along with antibodies against this disease.
• Vaccination against hepatitis B effectively prevents the disease.
• Vaccination against the papillomavirus is recommended for girls and boys aged 11 to 14 years old.
• The HAS recommends:
• The expansion of anti-HPV vaccination with GARDASIL 9 for all boys aged 11 to 14 years old according to a 2-dose schedule 6 months apart (applicable in January 2021),
• Possible catch-up for adolescents and young adults aged 15 to 19 years old according to a 3-dose schedule (M0, M2, M6),
• The maintenance of a specific vaccination recommendation by GARDASIL 9 for men who have sex with men up to the age of 26 according to a 3-dose schedule.

Note: if the condom is also a contraceptive method, all contraception does not protect against STIs.

Thus, the other means of contraception do not make it possible to avoid transmitting or contracting an STI:

• to pills;
• the IUD;
• l’implant ;
• the patch;
• the contraceptive ring;
• spermicides.

These are contraceptives whose sole purpose is to avoid an unwanted pregnancy.