Sexually Transmitted Diseases Health Article

Psychosocial factors

One study of college students examined the relationship between sexual behavior, substance use, and specific constructs from social cognitive theory (i.e., perceptions of self-efficacy, vulnerability to HIV risk, social norms, negative outcome expectancies of condoms, and knowledge of HIV risk and prevention). The results indicate that although young men expected more negative outcomes of condom use and were more likely to have sexual intercourse under the influence of alcohol and other drugs, young women reported perceptions of higher self-efficacy to practice safer sex. The study further revealed that perceptions of higher self-efficacy to engage in safer sexual behaviors, perceptions of fewer negative outcomes of condom use, and less frequent alcohol and drug use with sexual intercourse were the best predictors of safer sexual behaviors.

Evaluating STD risk

The information, motivation, and behavioral skills (IMB) model is one method of evaluating risk for STDs. This model posits that information, motivation, and behavior are the primary determinants of AIDS-related preventive behavior. Specifically, the model asserts that information regarding the transmission of HIV and information concerning specific methods of preventing HIV (e.g., condom use, decreasing the number of partners) are necessary prerequisites of reducing risk behaviors.

Motivation to change risk behaviors is another determinant of prevention and affects whether a person acts on his or her knowledge of the transmission and prevention of HIV. The IMB contends that motivation to engage in prevention behaviors is a function of one's attitudes toward the behavior and of subjective norms regarding prevention behaviors. Other critical factors which are hypothesized to influence motivation to engage in prevention behaviors are perceived vulnerability to acquiring HIV, perceived costs and benefits of engaging in prevention behaviors, intention to engage in prevention behaviors regarding HIV, as well as characteristics of the sex partner and/or the sexual relationship (e.g. primary vs. secondary partner).

Behavioral skills for engaging in specific prevention behaviors are a third determinant of prevention; it affects whether a knowledgeable, highly motivated person will be able to change his or her behavior to prevent HIV. Important skills required to engage in prevention behaviors include the ability to effectively communicate with one's sex partner about safer sex, refusal to engage in unsafe sexual practices, proper use of barrier-method contraceptives, and the ability to exit a situation when prevention behaviors are not possible. In addition, individuals who are able to practice prevention skills are presumed to have a strong belief in their ability to practice these prevention behavioral skills. Overall, the IMB asserts that information and motivation trigger behavioral skills to affect the initiation and maintenance of HIV prevention behaviors.

Symptoms of common STDs

The symptoms of some STDs may seriously affect an infected individual's quality of life or eventually become fatal, while others are so mild as to go undetected. The symptoms of some of the more prevalent STDs include:

• Gonorrhea: The most common symptoms among infected adolescent girls are vaginal discharge, bleeding between menstrual cycles, and painful urination. Among adolescent boys, common symptoms are burning or painful urination and pus-like discharge from the penis. Many infections, however, remain asymptomatic in both females (32%) and males (2%). Symptoms are similar among young children who have contracted gonorrhea from a sexual abuser.
• Chlamydia: Symptoms of chlamydia are similar to those of gonorrhea and sometimes difficult to differentiate clinically. Chlamydial infections are more likely to be asymptomatic than gonorrheal infections and thus are of longer duration on average.
• Syphilis: In primarily syphilis, the characteristic symptom is the appearance of a chancre (painless ulcer) at the site of initial exposure (e.g. external genitalia, lips, tongue, nipples, or fingers). In some cases, the infected individual will experience swollen lymph glands. In secondary syphilis, the infection becomes systemic and the individual experiences symptoms such as fever, headache, sore throat, rash, and swollen glands. During latent syphilis, symptoms go unnoticed. During the late stage of syphilis, the infection has spread to organ systems and may cause blindness, signs of damage to the nervous system and heart, and skin lesions.
• Herpes simplex virus: The symptoms of genital herpes include burning and itching of the genital area, blisters or sores on the genitals, discharge from the vagina or penis, and/or flu-like symptoms such as headache and fever.
• Human papillomavirus (HPV): The warty growths of HPV can appear on the external or internal reproductive organs of males and females but are commonly found on the labia minora and the opening to the vagina in females and the penis in males. They may be small and few or combine to form larger growths.
• Human immunodeficiency virus (HIV): Some persons who are newly infected with HIV have rash, fever, enlarged lymph nodes, and a flu-like illness sometimes called HIV seroconversion syndrome. This initial syndrome passes without intervention, and later symptoms, when T-cells become depleted, include weight loss, chronic cough, fever, fatigue, chronic diarrhea, swollen glands, white spots on the tongue and inside of the mouth, and dark blotches on the skin or in the mouth.