Sexually transmitted infections (or STIs) are pretty self-explanatory: an infection or organism that is transmitted by a sexual nature (either by vaginal, anal, or oral sex). They are extremely common, and many people don't know they have them because oftentimes they do not cause symptoms. This is why it is important to have routine screening, particularly if you are not in a mutually monogamous relationship or have a new partner. For all STIs, the best way to protect yourself is wearing condoms if you are unsure of the your partner's status – and wear them 100% of the time you have sex! Other forms of birth control DO NOT protect against STIs. Here are some of the most common STIs, when you should get screened, and how each are treated:
Human papillomavirus (HPV): HPV is the most common STI globally – most people who have sex have some strain of HPV at some point in their life. It is a virus that is transmitted via skin-to-skin contact, meaning you do not need to have penetrative sex in order to get it. There are over 200 different strains of HPV, which is why it is so common. Some strains can cause genital warts, which are cauliflower-like growths in your genital region that are benign, meaning they do not develop into cancer. These warts can be removed with either at-home treatments or at your healthcare provider's office. Other strains can cause cervical changes that can eventually lead to cervical cancer; these strains are often tested when you get a Pap smear (which is why it is so important to get regular screenings!). There is no cure for HPV, but oftentimes your body is able to clear it on its own. There is also a HPV vaccine widely available which covers the most common “high risk” strains that can lead to cervical cancer.
Chlamydia: Chlamydia is another very common STI – aside from HPV, it is the most common STI in Arizona. It is carried in either semen or vaginal fluids. Most people do not have symptoms, so regular screening is important. It is easily treatable, but if it is not identified and treated it can lead to long-term health complications, including infertility. It is tested either through your urine or with a swab. It is important to get tested every time you have a new partner, and annually at your well check up.
Gonorrhea: Gonorrhea is similar to chlamydia in the sense that it is transmitted via semen or vaginal fluids, and people don't usually have symptoms. It is usually tested for along with chlamydia through a swab or your urine, and should be tested annually or every time you have a new partner. Just like chlamydia, it can have long-term implications on your health and fertility if left untreated. It can also cause to newborn blindness if a pregnant person has it without being treated, which is why we test for it with every pregnancy and why it is recommended that erythromycin ointment is applied to your baby's eyes after birth.
Herpes Simplex Virus (HSV): Herpes has two strains – HSVI and HSV2. Both strains can cause painful, blister-like sores on either your face or genital region. They are transmitted via skin-to-skin contact, so it can occur with kissing, oral, anal, or vaginal sex. Usually the first outbreak (also called the “primary” outbreak) is the worst – people usually have flu-like symptoms followed by an outbreak of sores. They may also feel a tingling sensation prior to having a breakout. Additional outbreaks usually are less severe and are shorter than the initial outbreak. There is no cure for herpes, but the virus can be suppressed with medications to prevent or treat outbreaks. People who are pregnant need to have suppressive treatment at the end of their pregnancy to prevent an outbreak during birth. Herpes is VERY common, and nothing to be ashamed about. It generally does not lead to long term complications, and is basically just a skin condition. It can also be present in your blood for years before having symptoms, or you may never have symptoms, which is why testing is usually recommended only if you suspect an outbreak.
Syphilis: Syphilis is a less common but more serious STI. It is very treatable with antibiotics, but can lead to significant permanent medical complications if it is not identified and treated. It is most commonly spread through vaginal or anal sex, but can be transmitted via skin-to-skin contact. It generally starts off as a painless sort called a chancre which goes away after the first few weeks, and then eventually leads to symptoms that affects your whole body. Syphilis is detected in your blood. You should get tested with each new partner, and annually.
Hepatitis B: Hepatitis B, or Hep B, is a virus that infects your liver. There is no cure, however there is a vaccine that most people get when they are infants, so it is easily preventable. It is tested with your blood and should be tested annually and with each pregnancy.
HIV: Human Immunodeficiency Virus (HIV) is a serious STI. It is not currently curable, however there are many new treatments that make living with HIV manageable – people now can live long, normal lives with HIV. It has a big effect on your immune system and can make it hard to fight off infections, and if it is not caught early can lead to AIDs. It is carried in bodily fluids like semen, vaginal fluids, and breast milk, and people get it when it comes in contact with your blood or mucous membranes. It can also be transmitted from a pregnant person to their baby, which is why we test for it in pregnancy. It can be prevented by condom use, or by using either pre-exposure prophylaxis (PrEP) or post-exposure prophylaxis (PEP). It is tested either with a rapid test (usually an oral swab) or with your blood, and should be tested for annually and with each pregnancy.
STIs that can cause vaginitis: Vaginitis is the blanket term we use for vaginal infections, and can cause symptoms such as vaginal burning, foul odor with your discharge, painful urination, frequent urination, or vaginal itching. It can be caused by many things that are unrelated to sex (like yeast or bacterial vaginosis), but there are a few organisms that are sexually transmitted that could be causing those symptoms. These include trichomoniasis (or “trich”), mycoplasma, or ureaplasma. Trichomoniasis is commonly tested along with yeast and bacterial vaginosis if you have symptoms, but if that comes back as negative or you continue to have symptoms despite treatment, other causes such as mycoplasma or ureaplasma are tested. This is easily treatable with antibiotics.
Takeaways from this are 1) Wear condoms, 2) Get tested with new partners and annually.
Please ask your provider if you have any additional questions.