|Year : 2018 | Volume
| Issue : 3 | Page : 220-223
A retrospective study of the pattern of sexually transmitted diseases in teenagers attending sexually transmitted disease clinic during a 7-year period at a tertiary care centre
Jigna P Barot, Avanita D Solanki, Neela M Patel, Khushboo R Modi, Miral B Bodar
Department of Dermatology, AMC MET Medical College, NHL Medical College, Ahmedabad, Gujarat, India
|Date of Web Publication||28-Jun-2018|
Dr. Avanita D Solanki
11, Sulay Raw House, Near Saket-3, Bakeri City, Vejalpur, Ahmedabad - 380.051, Gujarat
Source of Support: None, Conflict of Interest: None
Background: Adolescent period corresponds to the age group of 10-15 years. While teenage period, which corresponds to 13-19 year of age group, is the stage of psychosocial development. More and more young people are becoming sexually active in their mid-teens making them vulnerable to contracting the STDs. Adolescents especially in urban areas have favorable attitudes toward premarital and extramarital sex. Material and Methods: This is a retrospective study conducted at tertiary care center. Data regarding STD in teenagers (13-19 year) and their sexual behavior from January 2009 to December 2015 was collected from STI clinic. Result: Total number of adolescent attended STI clinic was 381,out of which 200 were male and 181 were female. Most common STD in female was VVC and in male was nodular scabies. out of 381 patients 155 male and 93 female had confessed about indulging in sexual activity.10 patients were tested positive for HIV and 11 patients were tested positive for syphilis. Conclusion: There is increasing incidence & prevalence of STDs in adolescents due to risky sexual behavior. It is essential to include sex education in teaching methods.
Keywords: Sex education, sexually transmitted diseases, teenagers
|How to cite this article:|
Barot JP, Solanki AD, Patel NM, Modi KR, Bodar MB. A retrospective study of the pattern of sexually transmitted diseases in teenagers attending sexually transmitted disease clinic during a 7-year period at a tertiary care centre. Indian J Paediatr Dermatol 2018;19:220-3
|How to cite this URL:|
Barot JP, Solanki AD, Patel NM, Modi KR, Bodar MB. A retrospective study of the pattern of sexually transmitted diseases in teenagers attending sexually transmitted disease clinic during a 7-year period at a tertiary care centre. Indian J Paediatr Dermatol [serial online] 2018 [cited 2020 May 27];19:220-3. Available from: http://www.ijpd.in/text.asp?2018/19/3/220/223316
| Introduction|| |
Sexually transmitted infections (STIs) are a loosely defined constellation of infections and syndromes that are epidemiologically heterogeneous, but all of which are almost always or at least often transmitted sexually.
Unprotected sex with an infected partner is by far the most important risk factor for STI/human immunodeficiency virus (HIV) infection., STIs constitute a major public health problem for both developing and developed countries. STIs increases the risk of transmission of HIV infection causing immense need to understand the patterns of STIs prevailing in the regions of a country for proper planning and implementation of STI control strategies.
The share of adolescents engaging in sexual activity has declined over the past few decades. Despite the growing attention to prevention and health education, recent data indicate that the rates of unintended pregnancy and STIs remain higher for young adults than older adults and higher than the rates in most developed nations.
Adolescent period which corresponds to the age group of 10–15 years and teenage period which corresponds to 13–19 years are the stage of psychosocial development. A successful transition implies forming intimate relationships while avoiding the acquisition of sexually transmitted diseases (STDs).
Approximately 80% of college-age adolescents are sexually active and at risk for STIs in the United States. Over 4 million STIs occur in teenagers annually and young adults between the age of 18 and 24 years, while adolescents of 15–17 years of age have higher rates of STIs than any other age group in the United States.
During the past decade, there is overwhelming evidence that both ulcerative and nonulcerative STIs promote HIV transmission by augmenting HIV infectiousness and susceptibility. However, changes in social behavior have altered the pattern of STIs, with certain STIs getting stabilized and certain others showing downhill trend.
Multiple sexual partners and the lack or inappropriate use of contraceptive methods (condoms and others) are major risk factors associated with STDs.
Adolescents with mental health conditions have a higher prevalence of early intercourse, more sexual partners and sexual relations, less frequent use of condoms, more pregnancies, and STIs. In some studies, depression, lack of parental supervision, and poor communication between adolescents and their parents permeate early exposure to sexual activities. Others also reported that living with parents, parental regulation or supervision, high socioeconomic status, strong religious affiliation, and good communication skills constitute protective factors. In addition, the use of drugs or alcohol has been highly associated with the prevalence of adolescent risky sexual behavior.
Aims and objective
To study the patterns of STDs among teenagers attending STD clinic at the tertiary care center of municipal hospital of Ahmedabad.
| Materials and Methods|| |
This is a retrospective study conducted at Smt. Shardaben Hospital, Ahmedabad, from January 2009 to December 2015 from STI clinic.
This study only includes the patients of the age group of adolescence from 13 to 19 years. The detailed history of their disease was taken. The history of their sexual exposure was taken by the counselor.
HIV, venereal disease research laboratory, and Treponema pallidum hemagglutination assay testing was done in all patients after counseling. The details of all patients were kept confidential.
| Results|| |
STDs are more common in 17–19 years of age group. Out of 381 patients, 290 patients are of this group. STDs are almost equal in both males and females, but slight male predominance is there in both the age groups [Table 1].
|Table 1: Distribution of sexually transmitted diseases according to age group|
Click here to view
In various STDs in females, the most common STD is vulvovaginal discharge which is 126 out of 181 of total patients, followed by bacterial vaginosis and HP which were 17 and 16 patients, respectively [Table 2].
In various STDs in males, the most common STD is nodular scabies, out of total 200 patients, 125 (62.5%) patients are of nodular scabies, followed by genital molluscum 21 (10.5%) patients [Table 3].
In total of 200 males, exposure history is present in 155 and absent in 45. Males between the age group of 17-19 are more exposed to sexual activity, which are 122 (78.7%), out of them 92 were heterosexual,10 were homosexual and 20 were bisexual [Table 4].
In total of 181 females, exposure history is present in 93 and absent in 88. Here also, 17–19 age group females are more exposed to sexual activity, which were 86 (92.5%) – 53 were pregnant and 33 were not pregnant [Table 5]. All females were heterosexual.
Out of 381 patients, 10 patients were HIV positive, 6 females and 4 males. Eleven patients were TPHA positive, 9 females and 2 males. Out of 381 patients, 7 patients were positive for both HIV and TPHA, 5 females and 2 males [Table 6].
| Discussion|| |
STDs are more common in 17–19 years of age group. There is an increasing trend of risk behaviors among adolescents in India. More and more young people are becoming sexually active in their midteens. Sexual activity begins as early as from 10 years of age among street boys to mid and late teens among boys and girls in rural as well as in urban areas. Adolescents especially in urban areas have favorable attitudes toward premarital and extramarital sex. Average age at which young men and women marry has increased, premarital sex has increased, and there is increasing trend to earlier age of sexual debut. In addition, young age of sexual debut is associated with a greater number of sexual partners.
In our study, slight male predominance is found in both the age groups which is consistent with Jain et al.'s study. The attendance of female patients in the STD clinic mainly depended on referral from the gynecology clinic of this hospital or they were the spouses of the male cases, detected through partner notification. Attendance of females in low numbers in the STD clinic is due to several social, economic, and cultural barriers, leaving their reproductive tract infection/STI problems uncared for.
In our society, especially in rural areas, males are common visitors to the STI clinic than the females who are generally traced as a contact. Another reason for difference in the presentation may probably be due to the asymptomatic nature of infections in females, less degree of freedom to women to go outdoors, and lower awareness among women of the need for availing medical facilities.
In our study, vaginal discharge was the most common followed by ulcerative STD due to HP and syphilis. In the present study, Candida albicans and Candida species were found as the most common etiological agents of vaginal discharge. Bacterial vaginosis (BV) was found to be the most common infection, followed by Chlamydia trachomatis infection, trichomoniasis, and syphilis in women with vaginal discharge in Delhi. BV was also found in 33.3% of vaginal discharge cases in Nagpur. In another study in women in the community, it was reported that 41.5% of the women had BV, 18.6% candidiasis and 4.3% trichomoniasis, 28.7% chlamydiasis.
In our study, most common STD in male was nodular scabies followed by genital molluscum and HP. There was an increasing trend of viral STIs with reduction in those of bacterial origin probably due to higher and better antibiotics and empirical treatment provided by general practitioners. The recurrent and unremitting symptoms of viral STIs prompt these patients to report to a higher center for treatment and voluntary testing to rule out HIV disease.
In the present study, HIV seropositivity among STI patients was 4.24%; common STI associated with HIV was herpes genitalis (3 of 10 HIV positive), consistent with Devi et al.
In the present study, heterosexual contact was the most common type of sexual contact accounting for 94.4%; in accordance to Narayanan's study, 95.9% and Devi et al.'s study, 89.6%. The incidence of homosexual contact was 0.5% in our study as compared with 1.2% in Devi et al.'s study and Kavina et al.'s study.
From our study, we can say that the teenagers who are the future of the society still continue to present tough challenging situations to the health services.
WHO, along with many others in the field, strongly suggests that given appropriate information and services, trust, and equality between the sexes, young people will behave responsibly and well.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Marfatia YS, Sharma A, Joshipura SP. Overview of sexually transmitted diseases. In: Valia RG, Valia AR, editors. IADVL Textbook of Dermatology. 3rd
ed., Vol. 59. Mumbai: Bhalani Publishing House; 2008. p. 1766-78.
Aral S, Over M, Manhart L, Holmes KK. Sexually transmitted infections. In: Jamison D, Evans D, Alleyne G, Jha P, Breman J, Measham A, et al
., editors. Disease Control Priorities in Developing Countries. Washington, D.C: World Bank and Oxford University Press; 2006. p. 311-30.
UNAIDS. AIDS Epidemic Update: December 2005. Geneva: UNAIDS; 2005.
Shafii T, Burstein GR. An overview of sexually transmitted infections among adolescents. Adolesc Med Clin 2004;15:201-14.
Jain VK, Dayal S, Aggarwal K, Jain S. Changing t rends of sexually transmitted diseases at Rohtak. Indian J Sex Transm Dis 2008;29:23-5. [Full text]
Narayanan B. A retrospective study of the pattern of sexually transmitted diseases during a ten-year period. Indian J Dermatol Venereol Leprol 2005;71:333-7.
] [Full text]
Sharma VK, Khandpur S. Epidemiology of sexually transmitted infections. In: Sharma VK, editor. Sexually Transmitted Diseases and HIV/AIDS. Vol. 1. New Delhi: Viva Books; 2009. p. 16-7.
Vishwanath S, Talwar V, Prasad R, Coyaji K, Elias CJ, de Zoysa I, et al.
Syndromic management of vaginal discharge among women in a reproductive health clinic in India. Sex Transm Infect 2000;76:303-6.
Tankhivale NS, Pathak AA, Mundhda S. Study of vaginal infections caused by Gardnerella vaginalis.
Indian J Sex Transm Dis 2000;21:25-9.
Garg S, Bhalla P, Sharma N, Sahay R, Puri A, Saha R, et al
. Comparison of self reported symptoms of gynaecological morbidity with clinical and laboratory diagnosis in a New Delhi slum. Asia Pac Popul J 2001;16:75-92.
Devi SA, Vetrichevvel TP, Pise GA, Thappa DM. Pattern of sexually transmitted infections in a tertiary care centre at Puducherry. Indian J Dermatol 2009;54:347-9.
] [Full text]
Kavina BK, Billimoria FE, Rao MV. The pattern of STDs and HIV seropositivity in young adults attending STD clinic of civil hospital, Ahmedabad. Indian J Sex Transm Dis 2005;26:60-4.
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]