Beware of sexually transmitted diseases when engaging in sexual activity; how much do you know about their transmission routes?

Chapter Eight

Epidemic Prevention: A clear, colorless sky and pristine waters prevent the spread of infectious diseases – sexually transmitted diseases

Beware of venereal diseases caused by fickle nature.

Zhou Bangyan, the founder of the metrical poetry school in the late Northern Song Dynasty, was proficient in music and had long associated with courtesans and dancers, thus writing many erotic poems with imagery of "seeking flowers and willows" and "willows leaning and flowers swaying." One of his famous works, "A Youthful Journey," is a prime example.

The knife moves swiftly like water, the Wu salt is whiter than snow, and slender fingers peel a fresh orange. The brocade curtains are just beginning to warm, and the incense burner lingers, as they sit facing each other, tuning their zithers.

He asked in a low voice: Where shall I stay for the night? It's already past midnight on the city wall, and the horses slip on the thick frost. It would be better to rest, since few people travel there.

Li Shishi was a very famous courtesan during the Song Dynasty. Zhou Bangyan, a Grand Academician, often visited Li Shishi. Unfortunately, one day, Emperor Daojun also came to Li Shishi's house, and Zhou Bangyan hurriedly hid under the bed. Emperor Daojun brought a new orange from Jiangnan, which he and Shishi enjoyed together. Zhou Bangyan heard everything clearly and later composed this poem.

Throughout history, for many men, the prevailing view has been that "a wife is not as good as a concubine, and a concubine is not as good as a prostitute." Seeking pleasure among women seems to have become second nature to these men. While they enjoy themselves amidst countless beautiful and diverse women, they also develop venereal diseases.

In ancient times, sexually transmitted diseases (STDs) were commonly referred to as "venereal diseases." STDs are infectious diseases transmitted through sexual contact, with two aspects: transmission via sexual intercourse and infectiousness. Internationally, more than 20 infectious diseases caused by sexual activity or similar behaviors are classified as STDs. Common STDs include gonorrhea, syphilis, non-gonococcal urethritis, genital warts, chlamydia trachomatis, chancroid, genital herpes, trichomoniasis, and HIV/AIDS. Among these, syphilis, gonorrhea, genital herpes, genital warts, chancroid, non-gonococcal urethritis, lymphogranuloma venereum, and HIV/AIDS are listed as key STDs for prevention and control in China. STDs can be caused by viruses, bacteria, and parasites. Viral STDs include genital warts and genital herpes; bacterial STDs include gonorrhea and syphilis. Trichomoniasis and pubic lice are parasitic STDs.

Statistics show that more than 90% of sexually transmitted diseases are transmitted directly through sexual intercourse. Therefore, the main route of transmission of sexually transmitted diseases is through sexual contact.

Early signs of sexually transmitted diseases in men:

Urethral discharge: If there is purulent discharge from the urethral opening, which is thick, copious, and yellow, especially in the morning, it may be acute gonorrhea; if there is clear, sticky discharge from the urethral opening, which is small in amount, it may be non-gonococcal urethritis.

Urethral itching: In men, this symptom is often indicative of non-gonococcal urethritis or an early sign of gonococcal urethritis. Frequent urination, urgency, painful urination, and redness and swelling of the urethral opening: In men, this symptom, especially if accompanied by painful nocturnal erections, is often indicative of acute gonococcal urethritis.

Vulvar growths: If multiple infiltrative, grayish-white, flat, raised papules or nodules are seen on the vulva or perianal area, and are moist and easily eroded, accompanied by an odor, condyloma latum is most likely to be considered; if light red or grayish-brown, cauliflower-like or cockscomb-like warts with stalks are seen on the vulva or perianal area, and bleed easily, condyloma acuminata is most likely to be considered; if rice-grain-sized hemispherical papules with a central umbilicus and a waxy sheen are seen on the perianal area or vulva, and a cheesy substance can be squeezed out when the top is punctured, molluscum contagiosum should be considered.

Vulvar ulcers: If the ulcer is round, hard like cartilage, painless, and solitary, it is often considered to be a chancre (syphilis); if the ulcer is soft, with serrated edges, shallow, accompanied by pain and purulent coating, it is often considered to be a chancroid; if the ulcer develops from clustered blisters, is soft and painful, it is often considered to be genital herpes.

Full-body skin rash: If light red macules or dark red papules appear all over the body, without pain or itching, and may be seen on the palms and soles, with cuff-like desquamation around the rashes on the palms and soles, it is more likely to be a stage II syphilis rash.

Regarding how sexually transmitted diseases are transmitted, the following questions are of great concern to everyone:

1. Can masturbation transmit sexually transmitted diseases?

Masturbation refers to the sexual behavior of stimulating the genitals with one's own hands, everyday objects, or sexual aids by one's own hands or a sexual partner to achieve sexual pleasure, excitement, or orgasm. Theoretically, the primary tools for masturbation are one's own hands or masturbation devices. If the person performing masturbation does not carry pathogens, and the hands and devices have not previously come into contact with sexually transmitted disease pathogens, even with masturbation (a route of transmission) and a susceptible individual, one will not contract sexually transmitted diseases. Therefore, as long as one maintains good personal hygiene, keeps the genitals clean, avoids sharing towels, clothing, bowls, chopsticks, and even razors, toothbrushes, syringes, etc., and chooses restaurants and hotels with good hygiene conditions when traveling, people who masturbate using conventional methods will not contract sexually transmitted diseases. However, there are exceptions. For example, if the hands have come into contact with a patient or object carrying pathogens before masturbation and were not thoroughly cleaned, or if same-sex or opposite-sex individuals masturbate by touching each other's genitals, and one of them is an infected person, then there is an opportunity to transmit and contract sexually transmitted diseases. Moreover, masturbation can deplete physical strength and cause excessive friction on the genitals, commonly resulting in foreskin abrasion. In severe cases, it can lead to subcutaneous bleeding or secondary infections, reducing overall and local resistance and weakening the body's ability to resist various pathogens, including those causing sexually transmitted diseases, thus increasing the risk of infection.

2. Can you transmit sexually transmitted diseases through kissing?

This depends on whether either partner has a sexually transmitted infection (STI), the depth and intensity of the kiss, and whether either partner has any sores or lesions in their mouths. These factors largely determine whether the pathogen is alive at the time and whether there is close contact. Generally, kissing does not transmit STIs, but in special circumstances, it is possible. Why? If there are sores or lesions in the mouth, such as oral ulcers, the pathogen can enter the body through these openings if the other partner has an STI. Therefore, kissing can sometimes transmit diseases, including STIs. While generally not transmitted through kissing, there is a 1% chance of transmission. Of course, this route is extremely rare clinically. Oral transmission of STIs is primarily through oral sex, which is different from simple kissing. In general, casual kissing (polite or social) is relatively safe, while deep kissing (with saliva exchange and even bleeding) poses a certain risk for some STIs that can be transmitted through bodily fluids (blood), such as syphilis and HIV.

3. Is wearing a condom during sex absolutely safe?

To date, there are no reports of condoms being specifically effective in preventing any sexually transmitted infection (STI), especially against human papillomavirus (HPV). This is because warts and herpes are caused by viruses that remain latent in the body for life and can also be transmitted through non-sexual contact. During sexual activity, the virus can also be transmitted through contact with genitals, such as the scrotum contacting lesions in the female vulva or anus. Anal sex, oral sex, and other skin and mucous membrane contact can also transmit the virus. Even with condoms, they cannot completely cover all lesions. Therefore, ulcers in other areas can also cause transmission, not to mention lesions such as blisters that are not visible to the naked eye, which can also transmit the virus to a sexual partner. Of course, other non-herpetic lesions can also be transmitted in this way. In recent years, the number of female STI patients has increased rapidly, and the current male-to-female ratio of STI patients has reached 1.4:1. Literature reports that condoms are not entirely capable of preventing STI infection.