Understanding Sexually Transmitted Infections
Sexually transmitted infections, or STIs, are infections passed from one person to another through sexual contact including vaginal, anal, and oral sex. The World Health Organization estimates that more than 1 million STIs are acquired every day worldwide. In the United States alone, the CDC reports approximately 20 million new STI cases each year, with nearly half occurring among people aged 15 to 24.
Despite their prevalence, STIs remain surrounded by stigma and misinformation, which prevents many people from getting tested, treated, and taking preventive measures. Understanding the facts about STIs is essential for protecting your health and the health of your partners.
Common STIs and Their Symptoms
Chlamydia
Chlamydia is the most frequently reported bacterial STI, with over 1.8 million cases reported in the US annually. Most people with chlamydia have no symptoms, which is why screening is critical. When symptoms do occur, they may include abnormal discharge, burning during urination, and pelvic pain in women. Untreated chlamydia can cause pelvic inflammatory disease, which can lead to infertility. It is easily cured with antibiotics.
Gonorrhea
Gonorrhea is another common bacterial STI that often presents without symptoms, particularly in women. Symptoms may include discharge, painful urination, and in women, bleeding between periods. Gonorrhea can infect the throat and rectum in addition to the genitals. Antibiotic-resistant strains are an increasing concern, making proper testing and treatment essential. If left untreated, gonorrhea can cause serious complications including infertility and increased susceptibility to HIV.
Human Papillomavirus (HPV)
HPV is the most common STI, with nearly all sexually active people contracting at least one type during their lifetime. Most HPV infections clear on their own within two years, but persistent infections with high-risk strains can cause cervical, anal, throat, and other cancers. Low-risk strains can cause genital warts. The HPV vaccine is highly effective at preventing infection with the most dangerous and most common strains and is recommended for everyone through age 26.
Herpes Simplex Virus (HSV)
Genital herpes affects approximately one in six Americans aged 14 to 49. HSV-1 typically causes oral herpes but can also cause genital infections through oral sex. HSV-2 primarily causes genital herpes. Many people with herpes have mild or no symptoms but can still transmit the virus. While there is no cure, antiviral medications can reduce symptom severity, frequency of outbreaks, and transmission risk.
HIV
Human immunodeficiency virus attacks the immune system and, without treatment, progresses to AIDS. Early symptoms may mimic the flu. Modern antiretroviral therapy can suppress the virus to undetectable levels, allowing people with HIV to live long, healthy lives and effectively eliminating the risk of sexual transmission. Pre-exposure prophylaxis, or PrEP, is a daily medication that reduces HIV acquisition risk by over 99 percent when taken consistently.
Prevention Methods
Barrier Methods
External condoms, when used correctly and consistently, reduce the risk of most STIs by 80 to 98 percent. They are particularly effective against STIs transmitted through bodily fluids such as chlamydia, gonorrhea, and HIV. Internal condoms and dental dams provide additional options for vaginal and oral sex respectively. Use a new barrier for each sexual act and each type of sexual contact.
Vaccination
The HPV vaccine is recommended for everyone through age 26 and can be given as early as age 9. The hepatitis B vaccine, included in the childhood vaccination schedule, protects against a virus that can be sexually transmitted and cause chronic liver disease. These vaccines are safe, effective, and provide long-lasting protection.
Regular Testing
- All sexually active women under 25 should be screened annually for chlamydia and gonorrhea
- All pregnant women should be tested for syphilis, HIV, and hepatitis B early in pregnancy
- Everyone aged 13 to 64 should be tested for HIV at least once
- Men who have sex with men should be tested at least annually for syphilis, chlamydia, gonorrhea, and HIV
- Anyone with new or multiple sexual partners should be tested regularly
- Discuss your specific testing needs with your healthcare provider based on your sexual practices and risk factors
Communication With Partners
Open, honest communication with sexual partners about STI status, testing history, and prevention preferences is one of the most important yet often neglected aspects of sexual health. While these conversations can feel awkward, they demonstrate respect for both your own health and your partner's. Discussing sexual health before becoming intimate allows both partners to make informed decisions.
Getting Tested
STI testing is available through primary care providers, gynecologists, urologists, community health centers, Planned Parenthood clinics, and public health departments. Many tests require only a urine sample or blood draw and results are typically available within a few days. Some clinics offer rapid HIV testing with results in 20 minutes. Home testing kits are also available for several STIs and can be a convenient option for people who face barriers to clinic-based testing.
If You Test Positive
A positive STI result can be emotionally distressing, but most STIs are either curable with antibiotics or manageable with ongoing treatment. Inform your current and recent sexual partners so they can be tested and treated. Follow your healthcare provider's treatment plan completely, including finishing all prescribed medications. Avoid sexual contact until treatment is complete and your provider confirms it is safe to resume. Remember that having an STI does not define you, and seeking treatment is a responsible and courageous step.