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Women are biologically more likely to become infected than men if exposed to a sexually transmitted pathogen. Many STIs are transmitted more easily from man to woman than from woman to man. For example, the risk to a woman of getting Gonorrhoea from a single act of intercourse with an infected male partner could as high as 60 to 90 percent, while transmission from an infected woman to man is about 20 to 30 percent.
STIs are often asymptomatic in women, especially in gonorrhea and chlamydia. For example, in women with gonorrhea, 30 to 80 percent of them are asymptomatic, while less than 5 percent of men are asymptomatic. Similarly, as many as 85 percents of women with chlamydial infection are asymptomatic compared to 40 percent of infected. When an STI is suspected, it is often more difficult to diagnose in a woman because the anatomy of the female genital tract makes clinical examination more difficult. For example, a urethral swab and a Gram stain are sufficient to evaluate the possibility of gonorrhea in men, but a speculum examination of the cervix and a specific culture for gonorrhea have been required for women. Thus, women with gonorrhea or chlamydial infection are often not diagnosed with an STI until complications, such as pelvic inflammatory disease, occur.
According to the article ‘Disproportionate Impact of Sexually Transmitted Diseases on Women’ published by CDC, women have a higher risk of acquiring STI due to social norms and constructs. It says culturally, men are expected to have multiple sexual partners including sex workers without risking judgment from their social peers while women may feel they would face abuse if they refuse sex or ask for protection. This behavior effectively puts women at higher risk of acquiring STIs.Prevalence of Sexually transmitted infections in young adults and women under 25 years old are at the greatest risk of acquiring an STI for several reasons. The main one being that they are more likely to have unprotected sex with multiple partners. In addition, young people are at greater risk for substance abuse and other contributing factors that may increase the risk for STIs.
Although overall rates of gonorrhea have been declining in the general population for over a decade, this decline has been less pronounced among adolescents than in other age groups. The chlamydial infection has been consistently high among young adults; in some studies, up to 30-40 percent of sexually active adolescent females have been infected. Women are more likely to be infected than men because of their increased cervical ectopy. Cervical ectopy refers to columnar cells, is located on the outer surface of the cervix. Although this is a normal finding in adolescent and young women, these cells are more susceptible to infection. The higher prevalence of STIs among adolescents may also be due to having trouble accessing STI prevention and management services like lack of transportation, long waiting times, clinic hours clashing with school time, embarrassment attached to seeking STI services, a method of specimen collection, and concerns about confidentiality.
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