Sexually Transmitted Infections
What is an STD?
According to the CDC, sexually transmitted diseases (STDs), or sexually transmitted infections (STIs), are typically spread through vaginal, anal, and oral sex. STIs are common, especially among younger people who make up about half of new infections each year. In many instances, STIs present with no symptoms or mild symptoms and most STIs are easily treatable or curable.
Types of STDs
Chlamydia
Chlamydia is one of the most common STis and one of the easiest to treat. The penis, vagina, cervix, anus, urethra, eyes, and throat can be infected with chlamydia, often with no symptoms. Possible symptoms include:
- abnormal discharge
- burning sensation when peeing
- pain or welling in your testicles
You cannot get chlamydia from casual contact; sexual contact or childbirth are the ways chlamydia can be spread. Leaving chlamydia untreated can lead to chronic health issues like infertility, which is why it is so important to regularly test for STis.
Gonorrhea
Gonorrhea is another very common STI that can infect the penis, vagina, rectum, and throat and can be spread by oral, anal, and vaginal sex, as well as through childbirth. While gonorrhea often has no symptoms, but possible symptoms include:
- burning when peeing
- more vaginal discharge than normal or general discharge from the penis
- spotting between periods
- swollen and painful testicles
Testing for gonorrhea is a simple urine test or an oral/anal swab and is simple to treat with medication.
Genital Herpes
Genital herpes, another common STI, is caused by both herpes simplex virus type 1 and herpes simplex virus type 2. Genital herpes can be spread through oral, anal, and vaginal sex with someone who has a herpes sore, through skin in the genital or oral area of a partner with genital or oral herpes, saliva from someone with oral herpes, or genital fluids from someone with herpes. Genital herpes typically has no symptoms or mild ones including:
- Sores near the genitals, mouth, or rectum
- Pain when peeing
- Discharge that smells bad
- Irregular bleeding between periods
Genital herpes has no cure, but there are medications that prevent outbreaks and lessen your chances of spreading herpes to your sexual partners.
Human Immunodeficiency Virus (HIV) / Acquired Immunodeficiency Syndrome (AIDS)
Human immunodeficiency virus, or HIV, can be spread by both anal or vaginal sex and injection drug use through shared needles. HIV is more easily spread through anal sex than vaginal sex. HIV affects the immune system and can cause flu-like symptoms, including:
- Fever and chills
- Swollen lymph nodes
- Mouth ulcers
After the first infection, called stage one, those infected enter stage two of HIV infection, where people may have no symptoms but can still transmit the virus. An HIV infection can stay in this stage for over a decade even without treatment. Once a person’s immune system is severely damaged by HIV infection, they enter the third stage of disease called acquired immunodeficiency syndrome, or AIDS. People with AIDS experience an increase in severe illness because their immune system can no longer function properly. This is also the most infectious stage of disease. Untreated AIDS has a life expectancy of about 3 years.
Since the 1980s, there have been enormous strides in the prevention and treatment of HIV/AIDS. The development of antiretroviral therapy, or ART, has improved the lives of those diagnosed with HIV/AIDS. ART works to reduce the amount of HIV in a person’s body, which allows their immune system to function properly. ART can reduce the amount of HIV in a person’s body to an undetectable level, effectively eliminating the risk of HIV transmission through sexual contact. While HIV/AIDS is not curable, those diagnosed are able to live relatively normal lives because of ART.
Human Papillomavirus (HPV)
HPV is very common and does not have a cure; most sexually active people get HPV at some point in their lives, although most never know it. There are multiple types of HPV, and many HPV infections have no symptoms and go undetected. Some types of HPV, called oncogenic high-risk HPV infection, cause some types of cancers like cervical, penile, vaginal, and anal cancers and precancers. Other types of HPV cause warts in both the genital area and on the tissue around your vocal cords. Testing for HPV cannot detect whether the infection will be undetectable or progress to a disease. HPV tests are available and used for cervical cancer screenings. There are multiple vaccines that are extremely effective against preventing cancers and pre-cancers caused by HPV. There are treatments available for the conditions caused by HPV, but they do not treat the virus itself.
Syphilis
Syphilis is a sexually transmitted infection that can lead to serious health complications if left untreated. It is spread through vaginal, anal, and oral sex, as well as to unborn fetuses from their mothers. Over the past decade, syphilis cases have seen a concerning rise, making prevention and testing extremely important. There are three stages of syphilis.
Stage 1 Symptoms
- painless sores around the genital area, rectum or the lips and mouth area
These sores typically go away on their own – left untreated, syphilis will progress into stage 2.
Stage 2 Symptoms
- rashes and/or sores in the mouth, genital area, palms of your hands, or bottoms of your feet
- fever
- sore throat
- hair loss
- headaches
- weight loss
These symptoms go away by themselves with or without treatment. Without treatment, syphilis will either progress into the latent stage, where there are no signs or symptoms, or into the tertiary stage.
Stage 3 Symptoms
- Impacts the heart, blood vessels, and the nervous system
- Can result in death
Syphilis is a curable sexually transmitted disease with correct antibiotics, and lasting effects can be avoided if caught early. However, any damage caused by syphilis can be permanent, which makes safe sex and regular testing important for those who are sexually active.
Pubic Lice (Crabs)
Pubic lice, commonly known as crabs, are parasites that can infest the genital area and cause itching. While pubic lice typically infest the genital area, they can also infest the armpits, facial hair, eyebrows, and eyelashes. Pubic lice are spread through sexual contact; the parasites cannot live long away from a warm body. People can sometimes see pubic lice or their eggs with either the naked eye or a magnifying lens. There are many medicated creams and soaps that can be obtained without a prescription to treat pubic lice. You should also wash and dry any clothing or other fabrics that you came into contact with while having pubic lice with hot water and on the hot dryer cycle.
Trichomoniasis (“Trich”)
Trichomoniasis, commonly shortened to “Trich,” is the most common sexually transmitted infection that is curable. It is caused by a parasite that is spread during sex and infects the vagina, cervix, and urethra. Less than one third of trichomoniasis infections have symptoms. When symptoms do occur, they present as:
- itching or irritation inside the penis or of the genitals
- burning with peeing
- painful ejaculation
- abnormal discharge
Treatment for trichomoniasis involves oral medications, which all previous and current sex partners should also take to avoid reinfection.
Wouldn’t I Know If I Had An STI?
Not necessarily; the most common symptom of an STI is no symptoms. The only way to know if you have an infection is to get an STI assessment.
How To Prevent STIs
According to the CDC, there are many prevention methods that can protect against common STDs including:
- getting tested regularly (every 3-6 months if you are sexually active)
- correctly using internal or external condoms
- vaccinations (HPV)
- reducing your number of sex partners
Why should you get tested for STDs?
Engaging in any sexual activity that can spread STDs or STIs – like vaginal, oral, or anal sex – can put you at risk. Often times STDs can be present without any symptoms. To keep yourself and your sexual partners safe, you should be getting tested for STDs regularly (every 3-6 months) if you are sexually active.
What to expect when you get tested for STDs?
There are a few different types of testing depending on the type of STD and the testing site. Providers may take a urine sample, a blood sample, or a swab of your genitals. They also may be able to diagnose with a visual exam or a pap test. The following are the tests needed for the most common STIs:
- Urine Sample: Chlamydia, Gonorrhea
- Blood Sample: HIV, Genital Herpes, Syphilis (may also be taken with a swab of a sore)
- Genital Swab: Chlamydia, Gonorrhea, Genital Herpes, Trichomoniasis (Trich)
- Visual Exam: Genital Herpes, HPV (genital warts), Trichomoniasis (Trich)
- Pap Test: HPV (cervical cancer)
When should I get an STD assessment?
STI testing should be done routinely to maximize sexual health. The frequency in which to get tested varies by type of STI and demographics.
- All people ages 13-64 should be tested at least once for HIV in their lifetime.
- All sexually active people with vaginas under the age of 25 should be tested annually
for chlamydia and gonorrhea
- If people with vaginas over the age of 25 have risk factors such as new partners, exposure to STD, or multiple sex partners should also be annually tested for chlamydia and gonorrhea.
- People who are pregnant should be tested early on in their pregnancy for syphilis, HIV, gonorrhea, and chlamydia.
- Sexually active people with penises who have sex with other people with penises should be tested annually for syphilis, chlamydia, and gonorrhea or every 3-6 months for those who have multiple or anonymous partners. They should also be tested for HIV at least annually and would benefit from more frequent testing (every 3-6 months).
- Those who have oral or anal sex should speak with their provider about options for throat and rectal testing.
- Anyone who shares injection drug equipment such as needles should be tested for HIV at least annually.
How Much Does an STI test cost?
Testing for STIs can vary widely in cost. There are certain clinics and providers that will provide free or low-cost testing, local health departments, nonprofit organizations, and free health clinics are often sources for affordable options. Most insurance companies cover annual STI testing. Co-payments and deductibles will vary based on your specific plan. Contact your health insurance company to discuss what testing services your plan covers. If uninsured, STI testing can unfortunately be very costly, ranging from $100-$500 for the assessment. The STD Locator provides nearby testing locations including those that offer low cost or free options.
Will my parents know if I get tested?
Confidentiality is a concern many people have about getting tested for STIs, especially when they are on their parents’ insurance plan. In most states, including Ohio, minors over the age of 13 have the right to consent to a confidential STI assessment. If you are worried about insurance billing or have other concerns about seeing your family doctor, you should visit health clinics such as health departments or Planned Parenthood; their testing is completely confidential and will not show up on an insurance statement.
How do I tell my partner I have an STI?
All sex partners that you have had in the previous 60 days should be informed of your STI diagnosis. Even though STIs are very common, it can still be difficult to tell a previous sex partner. Here are some tips to having this conversation:
- Practice having the conversation aloud beforehand and go through the scenarios.
- Talk about this privately when you both have time.
- No one can read your thoughts! Let them know how you’re feeling and what you need as well as listening to their needs.
- If it is an ordinary bacterial infection such as chlamydia or gonorrhea, make sure your partner gets tested and treated as soon as possible.
- If it is a virus that needs long term management such as HIV or genital herpes, talk with your partner about how both of you are going to manage it going forward with care and treatment.
- If you have a new partner or multiple partners to inform and do not feel comfortable telling them, there are many anonymous forms of communication that will inform you such as stdcheck.com.
- Many providers will also prescribe treatment medication for infections like chlamydia to all partners exposed without having to get tested. The medication has no harmful side effects if taken when you do not have an infection.
Sexually Transmitted Infections – Linked References
Anzilotti, A. W. (Ed.). (2018, October). How Do I Get Checked for STDs Without My Parents Knowing? KidsHealth. From https://kidshealth.org/en/teens/stds-check.html
CDC – Adolescents and STDs – Basic Fact Sheet. https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm
CDC – Chlamydia – Basic Fact Sheet. https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm
CDC – Genital Herpes – Basic Fact Sheet. https://www.cdc.gov/std/herpes/default.htm
CDC – Gonorrhea – Basic Fact Sheet. https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea.htm
CDC – HIV – About HIV. https://www.cdc.gov/hiv/basics/whatishiv.html
CDC – Parasites - About Pubic “Crab” Lice. https://www.cdc.gov/parasites/lice/pubic/gen_info/faqs.html
CDC – Sexually Transmitted Diseases (STDs) – White STD Tests Should I Get? https://www.cdc.gov/std/prevention/screeningreccs.htm
CDC – Syphilis – Basic Fact Sheet. https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm
CDC – Trichomoniasis – Fact Sheet. https://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm
Fraser Health Authority. (2021). Types of STI Tests. Fraser Health. From https://www.fraserhealth.ca/health-topics-a-to-z/sexual-health/get-tested-for-stis/types-of-sti-tests#.Yj3QWS-z3jA
Mitton, A. (2022, February 16). How much does STD Testing Cost Without Insurance in 2022? K Health. From https://www.khealth.com/learn/healthcare/how-much-does-std-testing-cost-without-insurance/
Planned Parenthood Federation of America Inc. (2011, May 19). How do I tell my partner that I have an STD? Planned Parenthood. From https://www.plannedparenthood.org/learn/ask-experts/how-do-i-tell-my-partner-that-i-have-an-std