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  • Title: Epidemiology of sexually transmitted diseases.
    Author: Holmes KK, Bell TA, Berger RE.
    Journal: Urol Clin North Am; 1984 Feb; 11(1):3-13. PubMed ID: 6369705.
    Abstract:
    In the past decade, the recognized spectrum of sexually transmitted diseases has widened to a complex array of agents and syndromes. The authors correlate diseases with responsible pathogens and discuss the numerous and interrelated changes in industrialized societies that have contributed to the epidemics of sexually transmitted diseases. The spectrum of sexually transmitted diseases has widened over the past decade and the treatment and control of these diseases have become a common concern in private and institutional practice. This article analyzes the factors influencing the spread of sexually transmitted diseases, details their complications, and provides guidelines for reporting and contact tracing. Although surveys of sexual behavior, fertility, and morbidity have failed to address the epidemiology of sexually transmitted diseases, numerous changes in industrialized societies are considered to have contributed to their dramatic spread, including changes in the age structure of the population, increasing numbers of homosexual men, declines in the age at 1st intercourse, greater numbers of single and divorced persons and a preference for hormonal contraceptives and IUDs. Adaptive changes in the pathogens that cause these diseases, e.g., resistance to antimicobials developed by N. gonorrhoeae, have further influenced the clinical epidemiology of these diseases. Complications of sexually transmitted diseases include pelvic inflammatory disease, ectopic pregnancy, infertility, and cervical cancer. Urologists should report cases of syphilis, penicillinase-producing N. gonorrhoeae, and gonococcal pelvic inflammatory disease. In cases of other diseases, reasonable measures should be taken to treat the patient's sexual partners and specific etiologic diagnosis should be made. If specific diagnosis is not possible, certain syndromes (e.g., urethritis and macropurulent cervicitis) should be managed as if they were sexually transmitted.
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