Although many people consider intercourse as the only risky activity among sexual relationships, some sexually transmitted diseases ( STDs) can be transmitted without this occurring. “All sexual relations should be considered as risky practices, not just intercourse. And intercourse is not just vaginal sex, but also oral and anal,” says Dr Irene Fuertes, dermatologist at the Hospital Clínic, Barcelona. Some examples are genital herpes, papilloma or syphilis which are transmitted by direct contact with the skin or mucous membranes affected by the infection. “They are all very prevalent diseases. We deal with many such consultations and intercourse is not needed for them to be transmitted,” adds Dr Fuertes.
Dr José Luis Blanco, an internist at the Infectious Diseases Service at the Hospital Clínic, also highlights the dangers of oral sex: “With oral sex, it is often considered there is no risk of transmission; however, this is not the case. Even HIV can be transmitted through oral sex if the person with it has a detectable viral load.”
The best way to prevent these infections is through barrier methods and practising safe sex with measures to reduce the risk of contagion. For example, by limiting the number of sexual partners; avoiding having sex with unknown partners or when under the influence of drugs; as well as not sharing sex toys, unless they are sterilised or covered with a condom before each use. It is also recommended not to share materials that can break the skin (e.g. syringes or razor blades) with other people. Disposable or sterilised material must be used to pierce the skin (e.g. with piercings or tattoos) and it is best to be vaccinated, whenever possible. Periodic checks are recommended, especially if the above precautions are not taken.
The incidence of these STDs is high and sometimes they can go unnoticed.
Genital and oral herpes is an STD that can be transmitted very easily by contact with the infected area without intercourse. Actual statistical data is difficult to find as it is often not diagnosed or recorded. The most recent data established that there are 46.3 cases per 100,000 inhabitants.
Human papillomavirus (HPV) infection is one of the most common STDs worldwide. It is considered there are approximately 102.3 cases per 100,000 inhabitants, although many of these infections go unnoticed as they resolve spontaneously in a few months. In addition, HPV is an STD of special relevance since some types can cause cancer of the vagina, vulva, cervix or anus in women and cancer of the anus and penis in men.
Syphilis is an infection that is six times more prevalent in men than women. Most cases are diagnosed in men over 25 years of age who have sex with other men. The number of cases in Europe has increased since 2010. In 2019, 5,822 cases of syphilis were reported in Spain; that is, 13.29 cases per 100,000 inhabitants. As with other STDs, early detection and treatment reduce the chances of it leading to more serious problems. However, if it does go unnoticed, it can remain latent and spread to nerve or vascular tissues.
Many of these infections can go unnoticed, especially at first, and become chronic or leave permanent sequelae. Therefore, when a person is diagnosed, it is important they notify the people with whom they have had sexual relations. Good prevention and early detection are crucial to combat these diseases.
