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Chances are you’ve heard some sketchy information on the subject of sexually transmitted infections. Rumors and myths about STIs are common. We don’t all have access to reliable sex education, and even accurate information can become outdated. But maybe, most of all, talking about STIs can feel icky.
What’s your STI-Q? To find out, see the questions below.
STIs (sexually transmitted infections) and STDs (sexually transmitted diseases) are essentially different terms for the same thing: the bacteria, viruses, parasites, and other organisms that can infect people through oral, vaginal, and anal sex. STIs can be spread through bodily fluids such as semen, vaginal fluid, and blood, and via skin-to-skin contact.
Technically, “disease” implies that symptoms are present—which is often not the case with STIs. “Disease” may also feel more stigmatizing. Most sexual health educators say “STIs.”
Previously, STIs were called venereal diseases. They were named for Venus, the Roman goddess of love.
Human papillomavirus (HPV) is one of the most common STIs across all age groups in the US. In the US, 79 million people have HPV, and more than 14 million people become infected every year, according to the CDC.
Nearly all sexually active men and women become infected with HPV at some point in their lives. Many strains of HPV do not usually cause harm, but some strains of HPV can cause genital warts and cancers of the cervix, anus, penis, vulva, mouth, and throat.
How to reduce your risk of becoming infected with an STI
- Up to age 26, you can get a vaccine that protects against some of the most common strains of HPV. Research shows the HPV vaccine is helping to reduce the rates of genital warts and other strains of HPV among US teens, according to the CDC. You can also be vaccinated for hepatitis A and hepatitis B. Schedule a visit with your health care provider to get vaccinated. In some states you may be able to get the vaccine without parental consent.
- Use a condom and/or dental dam every time (see #9). These do not guarantee protection but do reduce your risk.
- If you’re sexually active, get tested once a year or with every new sexual partner (see #5). Discuss the availability and accuracy of tests with your health care provider.
- Get comfortable talking about sex and STI prevention. This means:
- Feeling empowered to talk about what you want or don’t want sexually
- Becoming comfortable with getting tested and asking partners to get tested as well
- Discussing the use of condoms (internal and external), lubrication, and dental dams (oral dams) to reduce exposure to STIs
- Discussing pleasure and what feels good to both of you
- Discussing methods of birth control to prevent pregnancy
These methods do NOT protect you from STIs
- Vaginal or anal douching before or after sex.
- Withdrawal before ejaculation (pulling out): Pre-ejaculate can still transmit infection, and some infections can be passed via skin-to-skin contact (e.g., HPV, herpes, and syphilis).
Approximately 750,000 teens become pregnant every year, 82 percent being unintended. About one in four will contract an STI, according to the American Sexual Health Association.
By age 25, most US adults have acquired at least one STI. To minimize your risk, see #6.
What. Human papillomavirus (HPV) is often confused with herpes (herpes simplex virus, or HSV). These are two different viruses. They are both transmitted through skin-to-skin contact.
HPV can cause genital warts and cancers of the cervix, anus, penis, vulva, mouth, and throat. Many strains of HPV do not usually cause harm, however. Men and women up to age 26 can get a vaccine that protects against some strains of HPV. Talk to your health care provider (see #2).
Herpes can cause sores at the point of infection, which may be in the genital area or on the mouth (e.g., cold sores). Many people who have been infected with herpes experience no symptoms or have mild symptoms that they attribute to other conditions. Treatment can help minimize the symptoms and lower the chance of transmission (see #10).
Getting tested for STIs is a gateway to treatment and helps you protect yourself and your partner(s). Most tests are noninvasive and simple. Get tested for these conditions once a year or whenever you have a new sexual partner. Discuss with your health care provider whether to get tested for other STIs as well.
- Herpes, if you’re having symptoms.
Medication can help minimize outbreaks but cannot cure herpes.
What’s the test like? Testing usually involves a health care provider taking a swab of the affected area and/or a blood test.
- Chlamydia and gonorrhea
These can be present without symptoms and can cause fertility problems in men and women if left untreated. Both are curable with antibiotics.
What are the tests like? Usually a health care provider will ask for a urine sample or take a swab of the genital area.
One in six people in the US who have HIV do not know it. If you’re at high risk of HIV, check out pre-exposure prophylaxis or PrEP. This medication can help reduce your risk.
What’s the test like? A swab can be taken from the inside of the mouth or a health care provider will take a blood sample.
Can cause severe complications such as brain damage or blindness if left untreated (usually after many years). It can be cured with antibiotics, but antibiotics cannot reverse any permanent damage caused by the disease. New cases are most common in men who have sex with men.
What’s the test like? It usually involves a blood test or a sample taken from a sore.
Teens and young adults are the most at-risk demographic for STIs. Rates of chlamydia and gonorrhea are highest in people aged 20–24.
Are STIs your fate? No. To minimize your risk of becoming infected:
- Use a condom or dental dam every time.
- Get tested with every new sexual partner or once a year if you have the same partner.
- Get comfortable talking about sex and STI prevention.
Why are teens and young adults at greater risk of STIs?
- Behavior: e.g., not using safer sex methods, having multiple sexual partners, and not getting tested. You can control behavioral risks.
- Culture: e.g., discomfort talking about sex and STI prevention, pressure to have sex, and expectations associated with gender roles. Being aware of these influences can help you address them.
- Biology: The physical development of young adults can make you more susceptible to STI infection. For example, in young women, the surface of the cervix is more exposed to some sexually transmitted organisms (e.g., HPV) than in older women.
Often, an STI infection doesn’t look like anything.
Most STIs don’t have visible symptoms. People who look perfectly healthy can be infected with STIs.
If you’ve ever looked at pictures of STI symptoms, be warned: In real life, symptoms often don’t look like those images. And most symptoms aren’t visible anyway.
How to know if you or your partner has an infection: STI testing is the only way.
- Have the discussion in advance. Don’t wait until you’re caught up in the moment.
- Make the first move—a conversational move. Don’t wait for them to initiate the STI talk.
- Explain that this is not about trust and it’s not about cheating.
- If you’re anxious, acknowledge it: “OK, so this is awkward, but I’m pretty sure we can handle awkward. It’s important to me that we go get tested together.”
- If a partner tells you they have an STI, respect their honesty and maturity and their consideration for you and your needs. Protect their confidentiality.
- If you discuss this sensitively and yet your partner doesn’t want to get tested, be cautious. Healthy relationships require mutual respect and responsibility.
Are students using condoms frequently?
Yes. About 60 percent of sexually active students reported using a condom for birth control the last time they had sex, according to the 2015 Youth Risk Behavior Surveillance Survey.
Can any other method help prevent both STIs and pregnancy?
No—only condoms (internal and external versions). Latex and latex-free (e.g., polyurethane) condoms are available and are proven to reduce the risk of transmitting STIs. For oral sex involving a penis, you can use a dry, lubricated, or flavored condom. Putting lubrication inside the condom increases sensitivity for both partners and makes the condom easier to put on.
Does condom size matter?
Yes. The condom may stretch, but is it comfortable and pleasurable? Too tight, and the elastic base could cut off blood flow or cause discomfort. Too loose, and it could come off during sex. Condoms are available in varying shapes and sizes, so explore the best fit.
What’s a dental dam?
Dental dams (oral dams) probably lower your risk of STIs (but not pregnancy). A dental dam is a thin cover placed over the vulva or anus for oral sex. You can cut a condom or medical glove into a dental dam, or substitute plastic wrap. The effectiveness of dental dams (including plastic wrap) in preventing STI transmission has not been adequately studied; nevertheless, the use of dental dams is recommended by many sexual health professionals.
How can I get some?
Dental dams are available in some specialty stores, such as condom stores, or online, for about $1.50 each.
The earliest known image of a condom is in a painting created 12,000–15,000 years ago in what is now France.
More people have a cat than have herpes type 2.
Herpes type 2 (HSV2) is traditionally known as genital herpes. In the US, 16 out of 100 people aged 14–49 have genital herpes (CDC). That translates to 50 million people, with 776,000 new cases each year.
More people have herpes type 1 than have a cat.
Herpes type 1 (HSV1) causes cold sores and genital sores. In the US, more than half of people aged 14–49 (54 percent) have HSV1 (CDC). Among teens, the rate is 3 in 10. Although we think of HSV1 as causing cold sores, this strain of the virus can be transmitted through oral sex and is responsible for more cases of genital sores than HSV2 is.
Herpes is very common.
To reduce your risk of acquiring or passing on a herpes infection, use a condom or dental dam every time you are sexually active.
Christine Sturgeon, community educator in sexual and reproductive health at the Sheldon M. Chumir Health Centre, Alberta.
Pierre-Paul Tellier, MD, director of student health services, McGill University, Montreal, Quebec.
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