Every year, nearly 20 million new STIs occur in the United States, half of which infect young people ages 15-24. Yes, half. There's no need to be alarmed, but it is important to be aware. Understanding the following will make it a little easier to spot the early signs of STIs, and help you take control of your own sexual health, while simultaneously being considerate of existing or potential partners. Remember, the best way to avoid contracting/passing on an STI is to 1. use condoms/dental dams 2. get tested regularly if you are sexually active, especially with several partners, and 3. communicate honestly with your partner.
What is a Sexually Transmitted Infection (STI)?
An STI is an infection passed from one person to another via sexual contact with genital, anal and oral areas. Because many people who have STIs don’t have obvious symptoms, it’s important to always have safe sex.
How are STIs caused?
STIs are caused by the spread of bacteria, viruses or parasites. Chlamydia, gonorrhea and syphilis are caused by bacteria. AIDS, genital herpes, hepatitis, genital warts, and cervical cancer are caused by viruses. Trichomoniasis and pubic lice are caused by parasites.
Do STIs have symptoms?
Not always. That’s why STIs can only be diagnosed through testing. However, common symptoms to watch out for include:
- a burning sensation when urinating
- pain during sex
- unusual bleeding from the vagina after sex or between periods
- unexplained fatigue, night sweats, and weight loss
- sore throat, swollen glands groin or neck area, fever, and body aches
- unusual discharge from the vagina, penis, or anus
- itchiness around the genital area
- rashes, sores, or small lumps on or around the penis, vagina, or anus
Other than abstaining from sex entirely, internal and external condoms offer the best protection against STIs. A dental dam, which is a thin square of latex, can be used to prevent the spread of sexually transmitted infections during oral sex. Dams should be placed on the vulva or anus when the mouth, lips, or tongue are used for sexual stimulation. This barrier method keeps partners' body fluids out of each other's bodies and prevents skin-to-skin contact. The Sheer Glyde dam has been approved by the FDA for safer sex. They are even available in a variety of “fun and fruity” colors and flavors. You can also create your own dental dam using non-microwavable (nonporous to prevent bacteria and viruses from passing through) Saran Wrap, an internal or external condom that has been cut open, or a latex glove with the fingers cut off and one side cut down. Note: These methods are only effective when they cover the infected area. That’s why it is critical to swap sexual histories with your partner. It may feel awkward to ask your partner, but it’s totally a totally normal, healthy, and important conversation to have (#respect).
Can people who don’t have sex with multiple partners still get STIs?
Yes. Even if you’re currently in a monogamous relationship, you or your partner might have been previously infected without knowing it. Since STI symptoms may not show for months or even years or not at all, the only way to be sure you’re STI-free is to get tested.
I’m in a long-term relationship. Do I still need to use a condom?
The choice is yours. If you’re in a long-term relationship and prefer to have sex without condoms, we suggest that you and your partner(s) get tested first. If you're nervous, go together! It could be a fun little date, and takes the pressure off each individual. Keep in mind that condoms not only help prevent the transmission of STIs, but protect against a potential pregnancy if a female-bodied partner is involved. Of course, there are other birth control options to explore, but only condoms prevent STIs.
Here are the most common STIs, explained:
Chlamydia is the most common STI that can easily be cured. Unfortunately, many people don't develop symptoms, but they can still infect others via sexual contact. Symptoms may include genital pain and discharge from the vagina or penis. Diagnosing chlamydia is done by taking a swab of the affected area or with a urine test. Chlamydia is easily treated with antibiotics, but left untreated can lead to serious long-term health complications, including infertility and chronic pain.
Caused by the human papilloma virus (HPV), genital warts are bumps or skin changes that occur on or around your genital or anal area. The warts are normally painless, but you may experience redness or itching. Occasionally, genital warts bleed. Because HPV is spread by skin-to-skin contact, you can skill pass the infection by rubbing without having penetrative sex. Treatments available for genital warts include creams and cryotherapy.
Cervical dysplasia (abnormal pap smear)
Cervical dysplasia is found by a Pap test. It's most often caused by the human papilloma virus (HPV) and may lead to cervical cancer if not treated. Most of the time, this condition causes no symptoms. It either can be treated or help prevent cervical HPV infections by getting an HPV vaccine.
A common STI marked by genital pain and sores, genital herpes is caused by the herpes simplex virus (HSV), which is a type of the same virus that causes cold sores. Some people develop small, painful blisters or sores only a few days after coming into contact with the virus. However, months to years after you've been infected, certain triggers can reactivate the virus, causing the blisters to develop again. Currently, there's no cure for genital herpes, but outbreaks can be controlled using daily antiviral medications.
Gonorrhea is a bacterial STI, in which at least half of females and many males experience no symptoms. When present, symptoms include painful urination and abnormal discharge from the vagina or penis. Diagnosed by a swab or urine test, gonorrhea can be treated with antibiotics. Left untreated, gonorrhea can lead to infertility and pain in the pelvic area.
Syphilis is a bacterial. It is simple to cure when treated immediately, but is infection that can have extremely serious complications when left untreated. Syphilis develops in stages, and symptoms progress with each stage. The first stage involves a painless sore on the genitals, rectum, or mouth. The second stage is characterized by a rash on the hands and feet. The final stage usually occurs many years later, and can result in heart problems, paralysis and blindness. When syphilis is treated properly (with antibiotics), the later stages can be prevented. Testing for syphilis usually requires a sample of blood or in rare instances spinal fluid.
Commonly transmitted by having unprotected sex or coming into contact with infected blood (for example, sharing needles to inject drugs). HIV virus attacks and weakens the immune system, our body’s natural defense against illness. Even though there's no cure for HIV, there are daily treatments that allow most people to live an otherwise healthy life. People with an initial HIV infection may feel healthy or experience a flu-like illness. Blood and saliva tests are normally used to test for HIV. The CDC estimates that more than one million people are living with HIV in the United States, with 1 in 8 remaining unaware of their infection. All the more reason to go get tested!
Caused by a small parasite, trichomoniasis causes foul-smelling vaginal discharge, genital itching, and painful urination in women. Males generally have little or no symptoms. For pregnant individuals, complications include a risk of premature delivery. Treatment involves both partners taking antibiotics.
Pubic lice (often called "crabs" because they look like crabs under a microscope) are six-legged creatures that typically infest hair in the pubic area, although they also can attach themselves to other body hair. Pubic lice are easily passed through close genital contact. It may take weeks before experiencing itching. Pubic lice can usually be successfully treated with over-the-counter creams or shampoos.
How often should I get tested?
Under 25, if you have sex, you should get tested every year. 25 and up, if you have sex (oral, anal, or vaginal sex), and have any of these apply to you, get tested if you have...
- a new sex partner
- more than one sex partner
- a sex partner with multiple sex partners
- a partner with a sexually transmitted infection
If you test positive for chlamydia or gonorrhea, you should be retested 3 months after having treatment to ensure that you are no longer infected.
The Center for Disease Control recommends testing for HIV at least once between the ages of 13-64. You should get more frequent testing if you...
- are a man who has had sex with another man
- had sex—anal or vaginal—with an HIV-positive partner
- had more than one sex partner since your last HIV test
- have injected drugs and shared needles or works (for example, water or cotton) with others
- have exchanged sex for drugs or money
- have been diagnosed with or sought treatment for another sexually transmitted disease
- have been diagnosed with or treated for hepatitis or tuberculosis (TB)
- have had sex with someone who could answer yes to any of the above questions or someone whose sexual history you don’t know
If any of these criteria apply, you should get tested at least once a year for HIV.
How do I tell my partner(s) I have an STI?
First of all, relax. Knowing your diagnosis means you can seek treatment. As we like to often say, knowledge is power. It is important to tell your present and past partner(s) if a test comes back positive, as their health is at risk, and they need to be informed to maintain their well-being. If the roles were reversed, wouldn't you want to know? (#goldenrule) If you contract something that is incurable, it is important to tell all future partners as well. Note: Not telling a partner about a confirmed diagnosis is a criminal offense in some states.
You may be fearful of rejection or embarrassment. What if they blame me, or think I'm weird? Fortunately, most STIs are easy to cure, and all are manageable to treat. Also, remember that 20 million number at the beginning? While we hope this statistic starts going down soon, STIs are hella common! The best option to approach the conversation is to be direct, honest, and open to (respectful) questions and concerns. If you don't know the answer, look it up together, or give them the space they may need. It is also helpful to provide suggestions for where to get tested.
If you need more information on sexually transmitted infections, STI testing, or how to handle common excuses for not wearing condoms, talk to your doctor or visit your local health clinic. For more information you can look at the CDC website.
Just because you’re young doesn’t mean you’re invincible. Be safe, stay smart, get tested, and talk to your partner(s)! And remember, life with an STI is manageable. Don't be scared by social stigmas and go get tested!
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