Part V: Understand the Realities of STIs

This is Part V of a larger resource, The Authoritative Guide to Safer Sex.  

A recent study reported that half of all sexually active teens and young adults will have contracted an STI before age 25. Whether you have been careless or are evaluating risk factors before choosing to have sex with a new partner (see Part II: You Need to Be Emotionally Ready), it’s important to recognize that STIs do happen. Some infections may lie dormant for months or years without discovery; adequate screening cannot be overemphasized.

Planned Parenthood has identified some STIs that are associated with different types of sex play and risk level. Consult the list for a full explanation, and read here about some of the more common infections and their treatment.

What Can I Expect When I Get Tested?

Many people assume that annual physicals automatically include testing for sexually transmitted diseases, but this is not true. Request specific testing for STIs when you schedule an appointment. You can be tested at a Planned Parenthood facility, many emergent care centers, or your private physician’s office. Consider testing if you are about to engage in sexual activity with a new partner (see Part II: You Need to Be Emotionally Ready) or if you think you may have been exposed to an STI (see Part IV: Learn the Proper Precautions). Higher-risk individuals, such as people with multiple partners, should be tested regularly.

Nearly all STIs can be accurately diagnosed with blood tests, urine samples, or cell testing performed from a tissue swab. The exception to this is HIV testing; this blood test sometimes does not reveal a true positive for 3-6 months after exposure, and repeat testing is often necessary.

When you arrive at a testing center, you may be asked to fill out a short questionnaire detailing your sexual activity and risk factors. For screenings, testing is often only a matter of blood and urine samples; you will generally receive answers within a week. If you are experiencing symptoms you will likely have a physical examination as well. If you have contracted an infection, follow-up with necessary treatment and counseling will be provided.

Common STIs and Treatment

While the list of infections that one can contract sexually is somewhat long, a handful are most common.

Gonorrhea can be a serious health risk. Affecting 600,000 women and men in the U.S. every year. Without the right treatment gonorrhea has serious long-term effects; it has quickly become a growing problem in the U.S. Like many STIs, gonorrhea can present as a “silent” infection with no outward indication; 4 out of 5 women and 1 out of 10 men have no symptoms at all. However, you may experience the following symptoms up to 2 weeks after exposure:

    • Pain or burning with urination
    • Discharge from the penis or vagina, often yellow or green
    • Fever
    • Severe abdominal pain and nausea
    • Painful intercourse
    • Swelling or tenderness in the vulva or vaginal area
    • Frequent urge to urinate

Left untreated, gonorrhea can cause serious pregnancy complications. Stillbirth and premature labor risk is high, and the infection can be passed to an infant during childbirth. Infants with gonorrhea can suffer from infection in the eyes, the blood, and the joints. Gonorrhea may also cause infertility in women and sterility in men. Three out of 100 gonorrhea sufferers may also develop a potentially damaging form of arthritis.

Gonorrhea has historically been treated with standard antibiotics. However, the germ has steadily developed a resistance to antibiotics and it is becoming more difficult to cure. In August 2012 the Centers for Disease Control (CDC) limited gonorrhea treatment to a class of powerful antibiotics called cephalosporins. There is growing concern among the healthcare community that gonorrhea is mutating into a superbug that resists all antibiotics.

HIV, the virus that leads to AIDS infection, infects about 40,000 men and women in the U.S. every year. The presence of the virus in the body presents no symptoms and is only detectable via a blood test. Since this test may not accurately reflect HIV infection within the first weeks of exposure, it is often recommended that patients repeat testing within 3 to 6 months. The virus is transmitted in bodily secretions such as blood, semen, breast milk, and vaginal fluids.

Unprotected sex with an HIV-positive partner is the most common method of infection, although the practice of needle-sharing among recreational drug users can also spread disease. Babies born to HIV-positive mothers can also contract the disease during childbirth or from breastfeeding. Transmission is more likely from repeated exposure to a partner with HIV.

AIDS is the late-stage illness resulting from the HIV virus. AIDS can be deadly, and there is no known cure. Symptoms of AIDs can include:

    • Skin rashes
    • Peripheral neuropathy
    • Discolored growth on the skin and inside the mouth
    • Frequent diarrhea
    • Extreme fatigue
    • Recurrent yeast and thrush infections
    • Shortness of breath
    • Deep, dry cough
    • Extreme weight loss
    • Decreased mental function

Chlamydia is the most common form of STI in the U.S.; 3 million Americans are infected annually, most under the age of 25. Chlamydia is usually silent, though women experience symptoms more than men. This infection may take up residence in the penis, vagina, throat, cervix, anus or eyes. Common symptoms of chlamydia may be:

    • Abnormal vaginal discharge, possibly yellow and malodorous
    • Bleeding after intercourse or between periods
    • Fever
    • Vaginal swelling
    • Increased urge to urinate

Because it is so often symptom-free, chlamydia can go untreated for long periods of time, increasing the likelihood of pelvic inflammatory disease (PID) and resultant infertility or sterility. A type of reactive arthritis is also associated with a long-undiagnosed chlamydia infection.

Chlamydia can be passed to infants during childbirth; these infants risk blindness and pneumonia, which can be deadly for a newborn. Luckily, chlamydia is very easy to treat with antibiotics.

Herpes is a common viral infection; it is estimated that 1 in 6 U.S. citizens have some form of herpes. Herpes simplex virus type 1 results in oral herpes, which most people refer to as cold sores or fever blisters. Herpes type 1 is prevalent in up 80% of Americans, many of whom have no current symptoms. While considered an annoyance by most, oral herpes can be treated with over-the-counter medications or antivirals in extreme cases.

Herpes simplex virus type 2 affects the genitals. Most people have no symptoms, though those who do report itchy, tingling blistery sores in the genital area. Some sufferers of genital herpes experience frequent recurrence, while others may never experience symptoms. A blood test is available that detects the presence of antibodies formed to fight the virus. If you have open sores, a visual diagnosis is possible but will likely be confirmed with a tissue swab.

There is no cure for herpes, but treatment with antivirals may make outbreaks less uncomfortable. Infants who are born during an active outbreak risk serious infectious complications; many women with genital herpes are advised to have Cesarean sections to avoid illness in their newborns.

Continue to Part VI: The Sexual Wellness Resources You Can Trust.
Return to The Authoritative Guide to Safer Sex: Table of Contents.