{"id":41413,"date":"2023-08-09T12:23:44","date_gmt":"2023-08-09T10:23:44","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=41413"},"modified":"2023-08-09T12:23:45","modified_gmt":"2023-08-09T10:23:45","slug":"sexualni-turistika-pohledem-infektologa","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=41413","title":{"rendered":"Sexu\u00e1ln\u00ed turistika pohledem infektologa"},"content":{"rendered":"\n

Na dovolen\u00e9 v exotick\u00fdch destinac\u00edch lid\u00e9 \u010dasto ztr\u00e1cej\u00ed z\u00e1brany a po hlav\u011b se vrhaj\u00ed do letn\u00edch dobrodru\u017estv\u00ed, v\u010detn\u011b t\u011bch sexu\u00e1ln\u00edch. Co v\u0161echno si pak mohou p\u0159iv\u00e9zt zp\u011bt dom\u016f popisuje MUDr. David Jilich, infektolog a vedouc\u00ed N\u00e1rodn\u00edho HIV\/AIDS centra na Klinice infek\u010dn\u00edch nemoc\u00ed FNB a 1., 2. a 3. LF UK.<\/em><\/strong><\/p>\n\n\n\n

Jak\u00e9 choroby sexu\u00e1ln\u00ed turistika nej\u010dast\u011bji generuje?<\/strong><\/p>\n\n\n\n

Do na\u0161eho oboru infek\u010dn\u00edho l\u00e9ka\u0159stv\u00ed spadaj\u00ed \u017eloutenky typu B a C a samoz\u0159ejm\u011b tak\u00e9 HIV. Pak je tu ale cel\u00e1 \u0159ada dal\u0161\u00edch pohlavn\u011b p\u0159enosn\u00fdch chorob spadaj\u00edc\u00edch do oboru ko\u017en\u00edho l\u00e9ka\u0159stv\u00ed \u2013 syfilis, gonorrea neboli kapavka, r\u016fzn\u00e9 typy chlamydiov\u00fdch infekc\u00ed, herpetick\u00e9 \u010dili oparov\u00e9 infekce. Zm\u00ednit mus\u00edme tak\u00e9 relativn\u011b nov\u00fd fenom\u00e9n opi\u010d\u00edch ne\u0161tovic. D\u00e1le je tu infekce lidsk\u00fdmi papilomaviry, co\u017e je onemocn\u011bn\u00ed zp\u016fsobuj\u00edc\u00ed mimo jin\u00e9 rakovinu d\u011blo\u017en\u00edho \u010d\u00edpku, ale tak\u00e9 zhoubn\u00fd n\u00e1dor kone\u010dn\u00edku nebo hltanu. Proti posledn\u011b zmi\u0148ovan\u00fdm vir\u016fm se ji\u017e n\u011bjakou dobu o\u010dkuje, ale po\u010det takto chr\u00e1n\u011bn\u00fdch jedinc\u016f je v \u010cR st\u00e1le n\u00edzk\u00fd. Kategorie pohlavn\u011b p\u0159enosn\u00fdch chorob je opravdu hodn\u011b \u0161irok\u00e1 a pestr\u00e1. Pom\u00fd\u0161let by na n\u011b m\u011bli l\u00e9ka\u0159i i z jin\u00fdch ne\u017e n\u00e1mi zmi\u0148ovan\u00fdch odbornost\u00ed. Kl\u00ed\u010dov\u00e9 jsou ale tak\u00e9 l\u00e9ka\u0159em spr\u00e1vn\u011b polo\u017een\u00e9 ot\u00e1zky, kter\u00e9 pravd\u011bpodobn\u011b budou choulostiv\u00e9 nebo i nep\u0159\u00edjemn\u00e9.<\/p>\n\n\n\n

Jak\u00e9 p\u0159\u00edznaky naka\u017een\u00fd \u010dlov\u011bk poci\u0165uje?<\/strong><\/p>\n\n\n\n

Na to je t\u011b\u017ek\u00e9 odpov\u011bd\u011bt, proto\u017ee jenom \u010d\u00e1st osob s t\u011bmito infekcemi m\u00e1 n\u011bjak\u00e9 konkr\u00e9tn\u00ed projevy. To znamen\u00e1, \u017ee \u010dlov\u011bk m\u016f\u017ee z\u00edskat pohlavn\u011b p\u0159enosnou chorobu a nemus\u00ed poci\u0165ovat v\u016fbec \u017e\u00e1dn\u00e9 p\u0159\u00edznaky. O to je to z\u00e1ludn\u011bj\u0161\u00ed a nebezpe\u010dn\u011bj\u0161\u00ed, proto\u017ee kdy\u017e naka\u017een\u00fd o infekci nev\u00ed, m\u016f\u017ee ji roz\u0161\u00ed\u0159it i na dal\u0161\u00ed osoby. Jindy se p\u0159\u00edznaky dostav\u00ed, ale s pom\u011brn\u011b velk\u00fdm zpo\u017ed\u011bn\u00edm.<\/p>\n\n\n\n

Jak tedy postupovat, kdy\u017e se n\u00e1kaza projev\u00ed, nebo kdy\u017e m\u00e1 \u010dlov\u011bk ur\u010dit\u00e9 pochybnosti?<\/strong><\/p>\n\n\n\n

Pokud se infekce projev\u00ed, p\u0159\u00edznaky pacienta do\u017eenou k n\u00e1v\u0161t\u011bv\u011b l\u00e9ka\u0159e a k vy\u0161et\u0159en\u00ed. Nej\u010dast\u011bji jde ke sv\u00e9mu praktick\u00e9mu l\u00e9ka\u0159i, na dermatovenerologii, gynekologii nebo urologii, podle typu infekce. A kdy\u017e l\u00e9ka\u0159i spr\u00e1vn\u011b vyhodnot\u00ed riziko, je z pohledu infektologa nap\u016fl vyhr\u00e1no, proto\u017ee m\u016f\u017eeme pacienta \u0159\u00e1dn\u011b vy\u0161et\u0159it a za\u010d\u00edt l\u00e9\u010dit. Bohu\u017eel nez\u0159\u00eddka se naka\u017een\u00ed boj\u00ed nebo styd\u00ed k l\u00e9ka\u0159i j\u00edt a popravd\u011b popsat situaci, proto\u017ee pohlavn\u011b p\u0159enosn\u00e9 choroby jsou spole\u010densky komplikovan\u00e9 t\u00e9ma.<\/p>\n\n\n\n

Jak\u00e1 vy\u0161et\u0159en\u00ed se k odhalen\u00ed t\u011bchto chorob pou\u017e\u00edvaj\u00ed?<\/strong><\/p>\n\n\n\n

N\u011bkter\u00e9 mikroorganismy se testuj\u00ed z krevn\u00edho vy\u0161et\u0159en\u00ed a n\u011bkter\u00e9 mikrobiologick\u00fdm d\u016fkazem z posti\u017een\u00e9ho m\u00edsta, tedy v\u00fdt\u011brem nap\u0159\u00edklad z mo\u010dov\u00e9 trubice, z pochvy, z dutiny \u00fastn\u00ed a podobn\u011b. Dal\u0161\u00edm probl\u00e9mem je, \u017ee lid\u00e9 p\u0159i rizikov\u00e9m kontaktu mohou z\u00edskat v\u00edce pohlavn\u011b p\u0159enosn\u00fdch chorob najednou. Dv\u011b, t\u0159i, ale vid\u011bl jsem i p\u0159\u00edpad s \u0161esti infekcemi, kter\u00fdmi se pacient nakazil p\u0159i jednom pohlavn\u00edm styku, tedy dle pacienta. V\u017edy je t\u0159eba vz\u00edt v potaz, \u017ee r\u016fzn\u00e9 infek\u010dn\u00ed choroby maj\u00ed r\u016fzn\u00e9 inkuba\u010dn\u00ed doby. Absolutn\u011b nejlep\u0161\u00ed je prov\u00e9st komplexn\u00ed vy\u0161et\u0159en\u00ed, tzv. venerologick\u00fd screening, kter\u00fd u n\u00e1s na Bulovce zaji\u0161\u0165uj\u00ed kolegov\u00e9 z Dermatovenerologick\u00e9 kliniky.<\/p>\n\n\n\n

Vra\u0165me se zp\u011bt k pohlavn\u011b p\u0159enosn\u00fdm chorob\u00e1m. Kter\u00e9 z nich jsou pro \u010dlov\u011bka nejnebezpe\u010dn\u011bj\u0161\u00ed?<\/strong><\/p>\n\n\n\n

Kdy\u017e se pod\u00edv\u00e1me na ohro\u017een\u00ed samotn\u00e9ho \u017eivota, jev\u00ed se jako nejnebezpe\u010dn\u011bj\u0161\u00ed infekce HIV. N\u011bkter\u00e9 viry zp\u016fsobuj\u00edc\u00ed \u017eloutenky neboli hepatitidy tak\u00e9 dok\u00e1\u017e\u00ed \u010dlov\u011bka zahubit, nebo\u0165 mohou vyvolat jatern\u00ed cirh\u00f3zu, selh\u00e1n\u00ed jater nebo vznik zhoubn\u00e9ho jatern\u00edho n\u00e1doru. Ale v p\u0159\u00edpad\u011b hepatitid se bav\u00edme o dob\u011b v \u0159\u00e1du des\u00edtek let, zat\u00edmco u HIV m\u016f\u017ee smrt nastat i d\u0159\u00edve, nap\u0159. u\u017e za deset let od naka\u017een\u00ed \u2013 samoz\u0159ejm\u011b u nel\u00e9\u010den\u00fdch pacient\u016f. Proto bych HIV ozna\u010dil za nejv\u011bt\u0161\u00ed infek\u010dn\u00ed hrozbu z \u0159ad pohlavn\u011b p\u0159enosn\u00fdch onemocn\u011bn\u00ed.<\/p>\n\n\n\n

Na druh\u00e9 stran\u011b jsou choroby, kter\u00e9 \u010dlov\u011bka nezahub\u00ed, jako nap\u0159\u00edklad chlamydiov\u00e9 infekce nebo kapavka, ale mohou zp\u016fsobit z\u00e1va\u017en\u00e9 dlouhodob\u00e9 komplikace, p\u0159\u00edpadn\u011b neplodnost nebo chronick\u00e9 z\u00e1n\u011bty. Syfilis v minulosti b\u00fdval p\u0159\u00ed\u010dinou \u00famrt\u00ed, ale pokro\u010dil\u00e1 st\u00e1dia zn\u00e1me sp\u00ed\u0161 z literatury nebo z film\u016f, dnes je d\u00edky \u00fa\u010dinn\u00e9 antibiotick\u00e9 l\u00e9\u010db\u011b u\u017e t\u00e9m\u011b\u0159 nev\u00edd\u00e1me.<\/p>\n\n\n\n

Kdy\u017e se bav\u00edme o sexu\u00e1ln\u00ed turistice, jsou n\u011bkter\u00e9 \u010d\u00e1sti sv\u011bta rizikov\u011bj\u0161\u00ed?<\/strong><\/p>\n\n\n\n

V\u011bt\u0161ina zmi\u0148ovan\u00fdch onemocn\u011bn\u00ed m\u00e1 celosv\u011btov\u00fd v\u00fdskyt. Pakli\u017ee \u010dlov\u011bk s\u00e1hne k nechr\u00e1n\u011bn\u00e9mu pohlavn\u00edmu styku v r\u00e1mci placen\u00e9 sexu\u00e1ln\u00ed slu\u017eby nebo s n\u00e1hodn\u00fdm partnerem, nelze \u017e\u00e1dn\u00fd takov\u00fd kontakt ozna\u010dit za bezpe\u010dn\u00fd nebo nerizikov\u00fd, a\u0165 k n\u011bmu dojde kdekoli na sv\u011bt\u011b. A pak u\u017e jde jen o m\u00edru rizika, nap\u0159\u00edklad ve vztahu k \u010detnosti v\u00fdskytu HIV. Logicky v zemi, kde je v\u00fdskyt infekce vy\u0161\u0161\u00ed, je vy\u0161\u0161\u00ed i riziko n\u00e1kazy.<\/p>\n\n\n\n

Ur\u010dit\u011b existuj\u00ed oblasti, kde by m\u011bl b\u00fdt \u010dlov\u011bk \u0159ekn\u011bme sexu\u00e1ln\u011b obez\u0159etn\u011bj\u0161\u00ed\u2026<\/strong><\/p>\n\n\n\n

Rizikov\u00e9 jsou zcela jist\u011b oblasti, kter\u00e9 jsou popul\u00e1rn\u00ed z pohledu sexu\u00e1ln\u00ed turistiky a poskytov\u00e1n\u00ed sexu\u00e1ln\u00edch slu\u017eeb. Tradi\u010dn\u011b se mluv\u00ed o Filip\u00edn\u00e1ch, Thajsku, Malajsii a podobn\u011b. Ono to nemus\u00ed b\u00fdt prim\u00e1rn\u011b destinac\u00ed jako takovou, ale t\u00edm, \u017ee zde vyu\u017e\u00edvaj\u00ed sexu\u00e1ln\u00ed slu\u017eby \u010detn\u00e9 osoby z r\u016fzn\u00fdch \u010d\u00e1st\u00ed sv\u011bta. Statisticky vzato lid\u00e9, kte\u0159\u00ed si o placenou sexu\u00e1ln\u00ed slu\u017ebu \u0159eknou, jsou ur\u010dit\u00fdm zp\u016fsobem rizikov\u00ed stran sv\u00e9ho p\u0159edchoz\u00edho chov\u00e1n\u00ed. U\u017e mohou b\u00fdt naka\u017eeni pohlavn\u00edmi chorobami a p\u0159es prostitutky a prostituty pak infekce \u201esd\u00edlej\u00ed\u201c s dal\u0161\u00edmi a dal\u0161\u00edmi sexu\u00e1ln\u00edmi z\u00e1kazn\u00edky. Proto si mysl\u00edm, \u017ee uveden\u00e9 zem\u011b jsou z pohledu sexu\u00e1ln\u00ed turistiky rizikov\u00e9, ale zmi\u0148ovan\u00e9 st\u00e1ty nejsou zdaleka jedin\u00e9.<\/p>\n\n\n\n

Jak je to s rizikem n\u00e1kazy HIV v r\u016fzn\u00fdch oblastech sv\u011bta?<\/strong><\/p>\n\n\n\n

Zaj\u00edmav\u00e9 je, \u017ee u viru HIV se v r\u016fzn\u00fdch oblastech sv\u011bta v\u011bt\u0161inov\u011b vyskytuj\u00ed ur\u010dit\u00e9 podtypy. Nap\u0159\u00edklad m\u00e1me \u010dlov\u011bka s nov\u011b zji\u0161t\u011bnou infekc\u00ed HIV, kter\u00fd byl vystaven mnoho\u010detn\u00e9mu riziku v r\u016fzn\u00fdch oblastech sv\u011bta \u2013 a speci\u00e1ln\u00edm vy\u0161et\u0159en\u00edm jeho HIV viru se d\u00e1 z toho podtypu odhalit, jestli se nakazil sp\u00ed\u0161e v oblasti v\u00fdchodn\u011b od n\u00e1s nebo nap\u0159\u00edklad v oblasti \u010dern\u00e9 Afriky \u010di Latinsk\u00e9 Ameriky. Ale pro l\u00e9\u010debn\u00fd p\u0159\u00edstup to nehraje \u017e\u00e1dnou z\u00e1sadn\u00ed roli. Je to d\u016fle\u017eit\u011bj\u0161\u00ed pro zji\u0161t\u011bn\u00ed tzv. epidemiologick\u00fdch trend\u016f, tedy kdy\u017e nap\u0159\u00edklad sledujete \u0161\u00ed\u0159en\u00ed nov\u00e9 varianty nebo zcela nov\u00e9 nemoci v dan\u00e9 zemi. Velice zaj\u00edmav\u00e9 to bylo v ned\u00e1vn\u00e9 dob\u011b v souvislosti s \u0161\u00ed\u0159en\u00edm opi\u010d\u00edch ne\u0161tovic. Ale jak ji\u017e bylo zm\u00edn\u011bno, v\u011bt\u0161ina pohlavn\u011b p\u0159enosn\u00fdch chorob m\u00e1 celosv\u011btov\u00fd v\u00fdskyt.<\/p>\n\n\n\n

Kter\u00e9 oblasti jsou tedy z pohledu HIV nejnebezpe\u010dn\u011bj\u0161\u00ed?<\/strong><\/p>\n\n\n\n

\u010cesk\u00e1 republika je obecn\u011b zem\u00ed s relativn\u011b n\u00edzk\u00fdm v\u00fdskytem HIV. To zjednodu\u0161en\u011b znamen\u00e1, \u017ee skoro v\u0161ude jinde na sv\u011bt\u011b je riziko n\u00e1kazy HIV virem vy\u0161\u0161\u00ed ne\u017e u n\u00e1s. A jsou zem\u011b, kter\u00e9 maj\u00ed mnohon\u00e1sobn\u011b vy\u0161\u0161\u00ed v\u00fdskyt, v sou\u010dasn\u00e9 dob\u011b se \u010dasto bav\u00edme o Ukrajin\u011b, kde je v\u00fdskyt HIV 20n\u00e1sobn\u011b vy\u0161\u0161\u00ed ne\u017e v \u010cR, v Rusku dokonce 40n\u00e1sobn\u011b. Tedy i pravd\u011bpodobnost, \u017ee se \u010dlov\u011bk p\u0159i jednom nechr\u00e1n\u011bn\u00e9m pohlavn\u00edm styku nakaz\u00ed je neskonale v\u011bt\u0161\u00ed.<\/p>\n\n\n\n

Tradi\u010dn\u011b nejposti\u017een\u011bj\u0161\u00edm kontinentem byla Afrika, na druhou stranu zlep\u0161en\u00ed situace v ot\u00e1zce HIV je tam nejmarkantn\u011bj\u0161\u00ed. V dostupnosti l\u00e9\u010dby, osv\u011bt\u011b i informovanosti se tato oblast obrovsk\u00fdm zp\u016fsobem posunula, proto\u017ee problematika HIV byla a z\u016fst\u00e1v\u00e1 v ot\u00e1zk\u00e1ch zdrav\u00ed celosv\u011btov\u00e1 priorita. Ostatn\u011b HIV je jedin\u00e1 diagn\u00f3za, kter\u00e1 m\u00e1 v OSN svoji vlastn\u00ed sekci v\u011bnuj\u00edc\u00ed se v\u00fdhradn\u011b tomuto onemocn\u011bn\u00ed. A to p\u0159esto, \u017ee existuj\u00ed srovnateln\u011b velk\u00e9 nebo dokonce v\u011bt\u0161\u00ed probl\u00e9my s infek\u010dn\u00edmi nemocemi, nap\u0159\u00edklad mal\u00e1rie nebo tuberkul\u00f3za.<\/p>\n\n\n\n

M\u016f\u017ee se \u010dlov\u011bk pohlavn\u011b p\u0159enosn\u00fdmi infekcemi nakazit i jinak ne\u017e p\u0159i pohlavn\u00edm styku?<\/strong><\/p>\n\n\n\n

V\u011bt\u0161ina z nich se d\u00e1 p\u0159en\u00e9st i jinak. HIV a hepatitidy se p\u0159en\u00e1\u0161ej\u00ed tak\u00e9 krevn\u00ed cestou. Tak\u00e9 syfilis, kapavka nebo opi\u010d\u00ed ne\u0161tovice v n\u011bkter\u00fdch st\u00e1di\u00edch se daj\u00ed p\u0159en\u00e9st i jinak ne\u017e sexu\u00e1ln\u00ed cestou, zejm\u00e9na \u00fazk\u00fdm kontaktem. Stejn\u011b tak se mohou lid\u00e9 nakazit v r\u00e1mci dom\u00e1cnosti p\u0159i nedodr\u017eov\u00e1n\u00ed hygienick\u00fdch pravidel. Ale obecn\u011b je to m\u00e1lo \u010dast\u00e9.<\/p>\n\n\n\n

Jak prob\u00edh\u00e1 l\u00e9\u010dba pohlavn\u011b p\u0159enosn\u00fdch chorob?<\/strong><\/p>\n\n\n\n

Ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f nen\u00ed nutn\u00e1 hospitalizace. Ur\u010dit\u00e9 v\u00fdjimky mohou b\u00fdt v p\u0159\u00edpad\u011b syfilidy, kde je z\u00e1konem na\u0159\u00edzen\u00e1 l\u00e9\u010dba a izolace kv\u016fli zabr\u00e1n\u011bn\u00ed \u0161\u00ed\u0159en\u00ed infekce na dal\u0161\u00ed osoby. Jinak l\u00e9\u010dba prob\u00edh\u00e1 ambulantn\u011b. Samotn\u00e1 l\u00e9\u010dba je rozd\u011blena mezi v\u00edce medic\u00ednsk\u00fdch obor\u016f, nej\u010dast\u011bji mezi ko\u017en\u00ed specialisty a infektology. Zaj\u00edmav\u00fd mezioborov\u00fd p\u0159\u00edstup k t\u00e9to problematice zvolili nap\u0159\u00edklad ve Spojen\u00e9m kr\u00e1lovstv\u00ed, kde vznikl nov\u00fd obor genitourin\u00e1ln\u00ed medic\u00edny, kter\u00fd pohlavn\u011b p\u0159enosn\u00e9 choroby \u0159e\u0161\u00ed komplexn\u011b. Podle m\u011b je to velmi dobr\u00e1 my\u0161lenka.<\/p>\n\n\n\n

Jak konkr\u00e9tn\u011b na Bulovce funguje mezioborov\u00e1 spolupr\u00e1ce v p\u0159\u00edpad\u011b t\u011bchto nemoc\u00ed?<\/strong><\/p>\n\n\n\n

Mezi na\u0161\u00ed Klinikou infek\u010dn\u00edch nemoc\u00ed a Dermatovenerologickou klinikou funguje spolupr\u00e1ce skv\u011ble. Je nezbytn\u00e1 a je ka\u017edodenn\u00ed. Pohlavn\u011b p\u0159enosn\u00e9 choroby jsou komplexn\u00edm probl\u00e9mem a je b\u011b\u017en\u00e9, \u017ee pacient se nakaz\u00ed v\u00edce infekcemi najednou. To znamen\u00e1, \u017ee my infektologov\u00e9 a ko\u017en\u00ed l\u00e9ka\u0159i um\u00edme diagnostikovat a vy\u0159e\u0161it dohromady v\u0161echny tyto infekce. U l\u00e9ka\u0159\u016f dal\u0161\u00edch specializac\u00ed, kte\u0159\u00ed se s t\u011bmito infekcemi mohou setkat, je z\u00e1sadn\u00ed, aby spr\u00e1vn\u011b vyhodnotili riziko, tedy aby nedoch\u00e1zelo k situac\u00edm, kdy odhal\u00ed a zal\u00e9\u010d\u00ed jednu pohlavn\u011b p\u0159enosnou chorobu a dal\u0161\u00ed n\u00e1kazy jim uniknou. Po spr\u00e1vn\u00e9 diagnostice u\u017e je na n\u00e1s a na ko\u017en\u00edch specialistech, abychom pacienta spr\u00e1vn\u011b zal\u00e9\u010dili. A z\u00e1m\u011brn\u011b nemluv\u00edm o Bulovce, proto\u017ee tato p\u00e9\u010de nen\u00ed soust\u0159ed\u011bna jen do fakultn\u00edch nemocnic. Naopak v\u011bt\u0161ina p\u00e9\u010de je v ter\u00e9nu, je soust\u0159ed\u011bna v ambulanc\u00edch, kam p\u0159ijde pacient \u010di pacientka s obt\u00ed\u017eemi nejd\u0159\u00edve.<\/p>\n\n\n\n

Jak by se naka\u017een\u00ed lid\u00e9 m\u011bli chovat t\u0159eba na sportovi\u0161ti nebo v rodin\u011b?<\/strong><\/p>\n\n\n\n

V na\u0161\u00ed terminologii tomu \u0159\u00edk\u00e1me b\u011b\u017en\u00e9 okol\u00ed, tedy lid\u00e9 v bezprost\u0159edn\u00ed bl\u00edzkosti naka\u017een\u00e9ho \u010dlov\u011bka vyjma sexu\u00e1ln\u00edch partner\u016f. B\u011b\u017en\u00e9 okol\u00ed obecn\u011b ve velk\u00e9m ohro\u017een\u00ed nebo riziku nen\u00ed. Naka\u017een\u00e9 osoby maj\u00ed po ur\u010ditou dobu, tedy dokud jsou infek\u010dn\u00ed, legislativn\u011b na\u0159\u00edzen\u00fd z\u00e1kaz nechr\u00e1n\u011bn\u00e9ho pohlavn\u00edho styku, aby nemohli nikoho dal\u0161\u00edho nakazit. Ale nap\u0159\u00edklad v dom\u00e1cnosti, na pracovi\u0161ti, v hromadn\u00fdch dopravn\u00edch prost\u0159edc\u00edch a podobn\u011b nen\u00ed pot\u0159eba podnikat \u017e\u00e1dn\u00e1 speci\u00e1ln\u00ed opat\u0159en\u00ed. Na\u0161t\u011bst\u00ed l\u00e9\u010dba v\u011bt\u0161inou pom\u011brn\u011b rychle zvr\u00e1t\u00ed onemocn\u011bn\u00ed do neinfek\u010dn\u00edho stavu. Je-li l\u00e9\u010dba zah\u00e1jena spr\u00e1vn\u011b, bakterie, viry nebo parazit\u00e1rn\u00ed organismy hynou a p\u0159est\u00e1vaj\u00ed b\u00fdt infek\u010dn\u00ed. V p\u0159\u00edpad\u011b HIV a virov\u00fdch hepatitid to n\u011bjakou dobu trv\u00e1, ale je b\u011b\u017enou sou\u010d\u00e1st\u00ed na\u0161\u00ed praxe, \u017ee automaticky v\u0161echny pacienty p\u0159esn\u011b instruujeme, jak se maj\u00ed chovat.<\/p>\n\n\n\n

Co byste poradil lidem, kte\u0159\u00ed vyr\u00e1\u017eej\u00ed na dovolenou a maj\u00ed z\u00e1lusk na n\u011bjak\u00e9 sexu\u00e1ln\u00ed dobrodru\u017estv\u00ed?<\/strong><\/p>\n\n\n\n

\u017de pochopiteln\u011b nej\u00fa\u010dinn\u011bj\u0161\u00ed metodou prevence je uk\u00e1zn\u011bn\u00e9 sexu\u00e1ln\u00ed chov\u00e1n\u00ed a jeden st\u00e1l\u00fd sexu\u00e1ln\u00ed partner, kter\u00fd je d\u016fv\u011bryhodn\u00fd. V ostatn\u00edch p\u0159\u00edpadech by se v\u017edy m\u011bli chr\u00e1nit. To znamen\u00e1 pou\u017e\u00edvat bari\u00e9rovou ochranu p\u0159i kontaktu s n\u00e1hodn\u00fdmi sexu\u00e1ln\u00edmi partnery, a\u0165 u\u017e je to \u017eena, mu\u017e nebo v\u00edce osob. A\u0165 u\u017e jde o jeden nebo v\u00edce podobn\u00fdch kontakt\u016f. A\u0165 u\u017e je ta slu\u017eba placen\u00e1 \u010di neplacen\u00e1. Prost\u011b v\u017edycky. Pou\u017e\u00edv\u00e1n\u00ed kondomu je vysoce \u00fa\u010dinn\u00e9 ve vztahu k v\u011bt\u0161in\u011b pohlavn\u011b p\u0159enosn\u00fdch chorob. Samoz\u0159ejm\u011b jsou praktiky, kde se kondom nepou\u017e\u00edv\u00e1 nebo pou\u017e\u00edt nelze, proto\u017ee t\u0159eba i p\u0159i l\u00edb\u00e1n\u00ed se lid\u00e9 mohou nakazit pohlavn\u011b p\u0159enosnou chorobou, i kdy\u017e to neb\u00fdv\u00e1 tak b\u011b\u017en\u00e9 a riziko nen\u00ed tak velk\u00e9 jako p\u0159i pohlavn\u00edm styku. Kondom nechr\u00e1n\u00ed jenom proti necht\u011bn\u00e9mu po\u010det\u00ed, ale p\u0159edev\u0161\u00edm p\u0159ed rizikem n\u00e1kazy pohlavn\u011b p\u0159enosn\u00fdmi chorobami.<\/p>\n\n\n\n

Je je\u0161t\u011b n\u011bco, co byste cht\u011bl \u010desk\u00fdm v\u00fdletn\u00edk\u016fm do exotiky vzk\u00e1zat?<\/strong><\/p>\n\n\n\n

Ur\u010dit\u011b bych neopomn\u011bl zm\u00ednit sexu\u00e1ln\u00ed chov\u00e1n\u00ed pod vlivem psychotropn\u00edch l\u00e1tek. \u010casto sta\u010d\u00ed i alkohol, nemus\u00ed j\u00edt p\u0159\u00edmo o drogy. Pod vlivem omamn\u00fdch l\u00e1tek se \u010dlov\u011bku m\u011bn\u00ed m\u00edra tolerance jeho vlastn\u00edho chov\u00e1n\u00ed, posouv\u00e1 se hranice toho, \u010deho by se za st\u0159\u00edzliva pravd\u011bpodobn\u011b nedopustil. Pak na ochranu nebo na detaily sexu\u00e1ln\u00edho chov\u00e1n\u00ed nemysl\u00ed. Je\u0161t\u011b si neodpust\u00edm p\u0159ipomenout, \u017ee pod vlivem amfetamin\u016f se jako jeden z \u00fa\u010dink\u016f na psychiku popisuje pot\u0159eba zv\u00fd\u0161it po\u010det sexu\u00e1ln\u00edch partner\u016f. Riziko n\u00e1kazy pak roste exponenci\u00e1ln\u011b. P\u0159ed t\u00edmto fenom\u00e9nem prov\u00e1zej\u00edc\u00edm dovolenkovou sexu\u00e1ln\u00ed turistiku bych cht\u011bl cestovatele d\u016frazn\u011b varovat. V\u0161em pak samoz\u0159ejm\u011b p\u0159eji kr\u00e1sn\u00e9 l\u00e9to a zdrav\u00fd n\u00e1vrat z dovolen\u00e9.<\/p>\n\n\n\n

BOX:<\/p>\n\n\n\n

3 ot\u00e1zky pro dermatovenerologa<\/strong><\/p>\n\n\n\n

Sexu\u00e1ln\u00ed turistika \u010dasto p\u0159iv\u00e1d\u00ed pacienty tak\u00e9 do ordinac\u00ed ko\u017en\u00edch specialist\u016f, proto jsme stru\u010dn\u011b vyzpov\u00eddali i doc. MUDr. Filipa Roba, Ph.D., p\u0159ednostu a prim\u00e1\u0159e Dermatovenerologick\u00e9 kliniky FNB a 2. LF UK.<\/em><\/strong><\/p>\n\n\n\n

Kter\u00e9 pohlavn\u011b p\u0159enosn\u00e9 infekce na klinice \u0159e\u0161\u00edte nej\u010dast\u011bji?<\/strong><\/strong><\/p>\n\n\n\n

Mezi nej\u010dast\u011bj\u0161\u00ed infekce pat\u0159\u00ed genit\u00e1ln\u00ed bradavice, kapav\u010dit\u00e9 a chlamydiov\u00e9 infekce. Diagnostika t\u011bchto onemocn\u011bn\u00ed nen\u00ed n\u00e1ro\u010dn\u00e1 a m\u00e1me k dispozici \u00fa\u010dinnou l\u00e9\u010dbu.<\/p>\n\n\n\n

Zvy\u0161uje se s l\u00e9tem jejich v\u00fdskyt?<\/strong><\/p>\n\n\n\n

V\u00fdskyt pohlavn\u00edch chorob se p\u0159es l\u00e9to v\u00fdrazn\u011b nezvy\u0161uje. V\u011bt\u0161ina t\u011bchto onemocn\u011bn\u00ed se v n\u011bkter\u00fdch specifick\u00fdch populac\u00edch jako jsou mu\u017ei maj\u00edc\u00ed sex s mu\u017ei \u010dasto objevuje v men\u0161\u00edch epidemi\u00edch, nap\u0159\u00edklad jako loni opi\u010d\u00ed ne\u0161tovice.<\/p>\n\n\n\n

Jak dlouho trv\u00e1 l\u00e9\u010dba nej\u010dast\u011bji se vyskytuj\u00edc\u00edch pohlavn\u00edch nemoc\u00ed?<\/strong><\/p>\n\n\n\n

U v\u011bt\u0161iny bakteri\u00e1ln\u00edch onemocn\u011bn\u00ed (nap\u0159\u00edklad kapavka, chlamydie, p\u0159\u00edpadn\u011b syfilis) posta\u010d\u00ed antibiotick\u00e1 l\u00e9\u010dba, \u010dasto jednor\u00e1zov\u00e1, v n\u011bkter\u00fdch specifick\u00fdch p\u0159\u00edpadech je nutn\u00e1 l\u00e9\u010dba del\u0161\u00ed. U virov\u00fdch infekc\u00ed, jako jsou nap\u0159\u00edklad genit\u00e1ln\u00ed bradavice, je nutn\u00e9 v\u011bt\u0161inou prov\u00e1d\u011bt opakovan\u00e1 o\u0161et\u0159en\u00ed.<\/p>\n","protected":false},"excerpt":{"rendered":"

Na dovolen\u00e9 v exotick\u00fdch destinac\u00edch lid\u00e9 \u010dasto ztr\u00e1cej\u00ed z\u00e1brany a po hlav\u011b se vrhaj\u00ed do letn\u00edch dobrodru\u017estv\u00ed, v\u010detn\u011b t\u011bch sexu\u00e1ln\u00edch. Co v\u0161echno si pak mohou […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":21129,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,11],"tags":[],"class_list":["post-41413","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-rozhovory","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/41413","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=41413"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/41413\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/21129"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=41413"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=41413"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=41413"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}