Emerging Trend of Viral STDs in Males in India

Sexually transmitted diseases or STDs are believed to be epidemiologically heterogeneous and are often transmitted through sexual intercourse. Studies have indicated a decreasing prevalence of bacterial STDs while that of viral STDs is on the rise. Currently, there has been a considerable decrease of common STIs such as syphilis and gonorrhoea. In fact, chancroid is almost extinct while other STIs such as lymphogranuloma venereum are now very rare.

There are several common STIs that affect men and those that affect women. Common STIs among men include:

  • Balanoposthitis
  • Nonvenereal genital dermatoses
  • Sexual dysfunction
  • Venereophobia

.Among women:

  • Vaginal cervical discharge
  • Vulvovaginal candidiasis
  • Bacterial vaginosis

STIs in women are particularly popular among female sex workers. In the general female population, STIs are normally spread through their spouses more so in the rural and semi-urban areas.

Researchers Murugan Swamiappan, Vijayabhaskar Chandran and Prathyusha Prabhakar from the Department of Skin and STD, Chengalpattu Medical College & Hospital, Chengalpattu, Tamil Nadu, India conducted a study with the aim to give an overview of the pattern of STIs among males at a tertiary care teaching hospital in Tamil Nadu, India over a period of 5 years.

Methods Used for the Study

The researchers collected data from clinical records of all male patients who visited the STI clinic at Chengalpattu Medical College Hospital, India from 2010 to 2014. The patients had visited the clinic with various complaints including sexual dysfunction, spermatorrhea, prostatorrhea, paraphimosis, phimosis and non-venereal genital dermatoses.

The study involved patients with clinical evidence of STIs and serological evidence of STIs only. The patients involved in the study were evaluated by venereologists who collected details such as age, marital status and sexual behaviour. STD testing for syphilis and HIV tests were conducted for all patients after counseling.

Findings of the Study

The number of male patients who visited the STI clinic during the study period were 4454. Out of these, 175 (3.93%) had STIs while 68 (1.53%) were HIV positive. The rest had candidal balanoposthitis, nonvenereal genital dermatoses, venereophobia and sexual dysfunction.

The majority of those with STIs were between 25 and 44 years. Admitted promiscuity was also a common thing among those with STIs. Common STIs were found to be genital wart 34.86%, genital herpes 32%, latent and secondary syphilis 12.57%, urethral discharge 10.86% and non-herpetic genital ulcerative diseases 9.71%. None of the patients studied were found to have either Lymphogranuloma venereum or donovanosis.

Among the HIV-positive patients in the study, seven of them also had genital herpes, six had genital warts and one patient had primary chancre. A constant rate of 33 to 38 STI cases every year was reported during the study period.

Lessons from the Study

The study found that viral STIs prevalence was significantly higher than bacterial STIs because viral STIs are incurable and recurrent in nature. The researchers also learnt that stigmatization resulted in the reluctance to seek early treatment. For this reason, patients prefer to seek treatment in private STD clinics because they believe they offer greater accessibility and confidentiality than public health facilities.  

The researchers suggest that health programmes should focus more on creating awareness about STIs and eradicating stigma to encourage patients to seek proper health care during the early stages foreffective treatment and prevent complications and transmission of the STIs.

Our Take…

There’s potential for a decrease in all types of STIs but this will require immediate treatment, awareness about STIs and eradication of stigma against those suffering from STIs. When this is achieved, STI transmission will reduce, decreasing its prevalence as well.

Read the full study here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740688/