Sexually Transmitted Diseases (STD) or Sexually Transmitted Infections (STI) are caused by the transmission of bacteria, viruses and parasites from person to person especially, but not exclusively, through sexual contact - some infections classified as STIs can be transmitted from mother to child, through non-sexual interpersonal contact or blood transfusions.
There are currently 30 identified sexually-transmissible bacterial, viral and parasitic pathogens(1). The most widespread STIs are: syphilis, HIV, gonorrhea, herpes, chlamydia, trichomoniasis, candidiasis, genital warts and cervical cancer (caused by infection with human papillomavirus – HPV), chancroid and pubic lice(2).
“Sexually Transmitted Infections” is the term increasingly preferred to “Sexually Transmitted Diseases”. It is argued that “STI” highlights that a person may be infected while not necessarily developing a disease or may only show symptoms long after the infection occurred. Until late in the 20th century, the medical and publicly-used term was “venereal disease”-named in the 17th century after Venus, Roman goddess of love(3).
While it is difficult to establish whether ancient Greek and Roman doctors treated infections that today would be classified as STIs, clearer sources show that Islamic medicine recognized and treated around the year 1000 a form of gonorrhea very likely identical in manifestation to the one circulating today(4) The discovery of penicillin in 1948, an antibiotic which cured syphilis and some strains of gonorrhea, inaugurated a period of “therapeutic optimism” about STIs(5). The first known cases of HIV, in 1981, and the subsequent global epidemic caused by the virus, as well as the periodic resurgence of syphilis since then, have had a sobering effect on the medical community and international public opinion(6).
Besides being objects of medical preoccupation, STIs have been central to the shaping of social, cultural and political attitudes towards sexuality, gender, state and scientific authority or global circulation since at least the Middle Ages. Early on, observers argued that syphilis had been brought back by sailors from the “newly-discovered” Americas and later, that it was spread because of modern intra-European armed conflict - for example, it was often called “The French Disease”, or “the Polish Disease”(7). Such judgements reflect how geopolitical games and cultural otherness are produced through discourses on infection and contagion.
Stigmatization and criminalization of male homosexuality in Europe resulted in high syphilis infections among MSM and difficulty in accessing treatments (see MSM)(8). The pattern would be repeated during the 20th century HIV epidemic, with AIDS receiving the homophobic “gay plague” label(9). The spread of HIV has led to the development of global public health regimes, and arguably, the trend has led to NGOization in the field of reproductive and sexual health (see NGOization). Thus, HIV/AIDS significantly shaped gay rights issues and activism in the U.S. and Europe, such as ACT UP in Europe. The dynamics of this history also continue to shape local groups and organizations in Lebanon, some of which have decided to be specialized in health issues including Marsa and the M Coalition.
According to the World Health Organization, from 2005 to 2008, there has been an increase in the global incidence of chlamydia (4.1 %), gonorrhea (21%) and trichomonas (11.2%)(10). The total incidence of selected curable STIs for the WHO Eastern Mediterranean Region was 26,4 million, in 2008- one of the lowest numbers by global regions(11). Globally, it was estimated that in 2010, 14,200,000 HIV-infected persons were eligible for antiretroviral therapy. In the North Africa and Middle East region there were an estimated of 150,000 such cases, the lowest global percentage(12)
