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Most high school health classes introduce the basics of safe sex. Still, there’s a vast amount of knowledge about sexually transmitted infections that seems anything but common. Unfortunately, STIs themselves are quite commonplace, infecting one in five people in the U.S., according to the Centers for Disease Control and Prevention.
While there’s no reason to be ashamed if you end up among this 20%, you’d probably rather avoid that fate. Fortunately, education and destigmatization are powerful tools for preventing the spread of STIs. So brush up on these not-so-fun facts your sex ed teacher might not have told you about STIs.
Everyone Should Be Testing
All sexually active people should get tested for STIs. The frequency of STI testing depends on various factors and the infection in question. The CDC, for example, recommends that all individuals between 13 and 65 get tested for HIV at least once. Women under 25 who are sexually active should be screened for chlamydia and gonorrhea each year. Women over that age who have certain risk factors (e.g., new or multiple partners) should follow suit.
Gay and bisexual men should likewise be tested for gonorrhea and chlamydia annually, adding testing for syphilis and HIV to that list. It is recommended that they test as often as every three to six months if they have sex with multiple or anonymous partners. Male or female, gay or straight, it’s always a good idea to retest any time you have a new partner.
There Are a LOT of STIs
There are dozens of known STIs, which can be bacterial, viral, or parasitic. These infections can be spread through vaginal fluids, semen, blood, and even skin contact.
The nature of the STI will influence the course of treatment. Most bacterial infections can be fully cured if they are treated early. Viral STIs can’t be cured and may require lifetime treatment and management.
STIs Don’t Always Have Symptoms
Several STIs, including chlamydia, gonorrhea, and HIV, can initially exhibit mild symptoms or even none at all. You can still pass these infections on to your partners, regardless of whether you show symptoms yourself.
That’s why testing is such an important factor in preventing transmission. Regular testing with each new partner, coupled with condom use, will help to ensure you are not inadvertently spreading STIs.
STIs Can Affect Fertility
Because chlamydia and gonorrhea are largely asymptomatic in women, some may fail to get timely treatment without intentional, regular testing. That could deal a fatal blow to their plans to start a family.
Over time, chlamydia and gonorrhea can lead to pelvic inflammatory disease. Left untreated, PID can cause scarring and other damage to a woman’s reproductive organs. The sad result may be permanent infertility.
You Might Not Automatically Be Tested for Two Common STIs
Often, doctors do not test for two of the most common STIs, herpes and human papillomavirus. Herpes is so widespread that doctors will usually only test for it if you are symptomatic or if you specifically ask.
Similarly, 80% of women will contract at least one strain of HPV at some point in time. Women are usually only tested for HPV after having an abnormal Pap smear; there is no test for men. Fortunately, the HPV vaccine has dramatically reduced infections and precancers caused by HPV in women.
Any Sexual Activity Can Spread STIs
You can be exposed to STIs through any kind of sexual contact. This includes anal and oral sex, as well as mutual masturbation.
In addition, STIs can spread to various body parts beyond the genitals. You can get gonorrhea and chlamydia in your eyes, and herpes can be spread orally. HPV can even cause throat cancer.
Some STIs Are Antibiotic-Resistant
If you have a bacterial STI, that’s usually good news — it can be cured completely with antibiotics. Not so fast, though. The CDC gave drug-resistant gonorrhea an “Urgent Threat” rating in its 2019 Antibiotic Resistance Threats Report.
There are several reasons for bacterial resistance, including genetic mutations in the bacteria, overprescription of antibiotics, and poor-quality antibiotics. These multi–drug resistant infections have serious effects on individuals and healthcare systems in both poor and higher-income countries.
Some STIs Cause Cancer
According to the CDC, HPV is the most common STI in the United States, and — as noted — it can lead to cancer. There are over 40 different types of HPV, which are separated into low-risk and high-risk categories. Low-risk HPV types are wart-causing, while high-risk HPV types are cancer-causing.
Most people who become infected with HPV will never know they have it. High-risk HPV affects both men and women, potentially causing cancers of the cervix, vulva, vagina, anus, penis, and throat.
Condoms Aren’t 100% Effective in Preventing STI Transmission
Even if you are regularly using condoms, they are not foolproof. Because there may be contact with areas of the body not covered by condoms, genital herpes is still a risk.
According to the CDC, nearly 12% of people aged 14 to 49 are infected with genital herpes. Many of those will have mild or even no symptoms at all. Mild symptoms may be so minor that they can be mistaken for a pimple or ingrown hair. Preventing transmission requires — you guessed it — getting tested for this common STI.
Yes, talking about STIs can be awkward. But they are a fact of life that obviously will not be going away. Sex is undoubtedly fun, but it also comes with the obligation of making informed and responsible decisions. The more you know, the better your ability to make choices that keep you and your partner safe and infection-free.