Safe Sex: STDs and STIs

What are they anyway?

Sexually transmitted diseases, or STDs (sometimes called sexually transmitted infections, or STIs) affect people of all ages, backgrounds, and from all walks of life. In the U.S. alone there are approximately 20 million new cases each year, about half of which occur among youth ages 15-24 years.

Getting the facts about STDs/STIs and sexual health is increasingly important. We invite you to explore our website and learn more about specific STDs/STIs, tips for reducing risk, and ways to talk with health care providers and partners.

Diseases that are spread through sexual contact are usually referred to as sexually transmitted diseases or STDs for short. In recent years, however, many experts in this area of public health have suggested replacing STD with a new term—sexually transmitted infection, or STI.

Why the change? The concept of “disease,” as in STD, suggests a clear medical problem, usually some obvious signs or symptoms. But several of the most common STDs have no signs or symptoms in the majority of persons infected. Or they have mild signs and symptoms that can be easily overlooked. So the sexually transmitted virus or bacteria can be described as creating “infection,” which may or may not result in “disease.” This is true of chlamydia, gonorrhea, herpes, and human papillomavirus (HPV), to name a few.


Statistics

  • One in two sexually active persons will contract an STI by age 25.

  • The Centers for Disease Control and Prevention (CDC) estimates that nearly 20 million new STIs occur every year in this country, half of those among young people aged 15–24.

  • Even though young people account for half of new STI cases, a recent survey showed only about 12% were tested for STIs in the last year.

  • CDC estimates that undiagnosed STIs cause 24,000 women to become infertile each year.

  • Researchers estimate that at least 80% of sexually active people will have an HPV infection at some point in their lifetime.

  • CDC data shows that about 42% of men and 40% of women aged 18-59 had genital HPV at that time.

  • Herpes infection is common. About 1 in 8 people aged 14-49 in the U.S. has genital herpes.

  • Symptoms of genital herpes often go unnoticed. Most people with genital herpes—close to 90%—don’t know they have the infection.

  • According to CDC, 1.1 million people in the US are living with HIV, and 1 in 7 of them don’t know it.


Reduce Your Risk

Being sexual with someone carries risks—risk of rejection, of unwanted pregnancy, of contracting a sexually transmitted disease/infection (STD/STI) or even a simple cold. Being sexual also can provide many physical, emotional and spiritual benefits, including physical fitness, emotional bonding, and a feeling of spiritual connection. Here we will examine some of the things you can do to assess your own risks and benefits so that you can enjoy the benefits important to you while decreasing your risk of contracting an STD/STI, having an unwanted pregnancy, or being coerced into sexual activity.

Decide on Your Boundaries

When deciding on their boundaries, people may consider such things as religious beliefs, cultural standards, personal desires and comfort levels, the type of relationship in which one is involved, the level of trust, communication and commitment within a relationship, the physical, emotional, spiritual benefits of sexual choices, the physical, emotional and spiritual risks of particular sexual choices, and the emotional perceptions of actual physical risks.

A few things to consider:

What are your reasons for choosing to have sex? What are the “benefits” you are hoping to enjoy? (Physical health benefits? Pleasure? Emotional connection? Fun? Spiritual connection?)

  • When and how often will you be tested for sexually transmitted disease/infection (STD/STIs)?

  • When and how often do you want your partners to be tested for STD/STIs?

  • What barriers do you want to use? Under which circumstances?

  • What barriers and other precautions do you want your partner(s) to use when being sexual with others, if you are in a sexually non-monogamous relationship?

  • Are you willing to risk a possible pregnancy? If not, what method of birth control will you use?

  • Do you have a plan of action that you intend to follow if, in spite of precautions, you are faced with an unwanted pregnancy, or an STD/STI?


Myths and Facts about STDs/STIs

MYTH: You can get herpes from a toilet seat: Herpes simplex virus (HSV) is spread by direct skin to skin contact. So unless you and another person are sharing a toilet seat at the same time, the toilet is not likely the source of the infection.

MYTH: You can’t get HIV from getting a tattoo or body piercing: There can be a risk for HIV or another blood-borne infection (like hepatitis B or C) if the instruments used for piercing or tattooing either are not sterilized or disinfected between clients. Any instrument used to pierce or cut the skin should be used once and thrown away. Ask the staff at the parlor about their equipment. They should show you what precautions they use, or don’t get pierced or tattooed there.

MYTH: A Pap test is a STD test: Pap tests are not specific tests for any sexually transmitted disease or infection (STD/STI). While some women think (or assume) that they are being tested for STDs/STIs when they have a Pap test, this is not the case. Talk to your healthcare provider about STD/STI testing and see if she or he recommends any tests for you.

MYTH: You can get HIV from a mosquito bite: HIV is not transmitted by mosquitoes. Studies conducted by the Centers for Disease Control and Prevention (CDC) and elsewhere have shown no evidence of HIV transmission from mosquitoes or any other insects—even in areas where there are many cases of AIDS and large populations of mosquitoes.

MYTH: You can’t get an STI just through oral sex: During oral sex, you can give your partner your STI and you can get theirs. Not all STIs are transmitted through oral sex, but some are.

MYTH: You can tell when someone has an STD/STI: Despite the gross pictures they showed you in health class, the majority of people with an STI have no symptoms of visible sores.

MYTH: I’ve been tested, I’m fine: The claim of having “been tested” isn’t always what it seems. Men and women can be tested for chlamydia, gonorrhea, syphilis and HIV. There is a blood test for herpes; however, it is always ordered by doctors and many people with herpes have no symptoms, so they never get tested.

There is currently not test to determine if a man has HPV, and while there is a test for women to see if they have the cervical-cancer-causing strains of HPV, there is no test for the other strains of HPV (including the kind that cause genital warts.)

So - just because someone claims they’ve been tested, doesn’t mean they’ve been tested for everything, and definitely doesn’t mean there’s no need to use a condom.

MYTH: I already had unprotected sex with my partner and I didn’t catch anything, so I don’t need to use a condom. You won’t always catch an STI the first time you have sex with an infected partner, but you’ll catch it eventually if you keep having unprotected sex with that person. That’s why it’s important, even if you’ve had unprotected sex in the past, to use a condom every time.

MYTH: I used a condom, so I can’t have an STI. A few STIs, like herpes and genital warts, can be spread just by naked skin-to-skin contact. But condoms are still the best protection we have against most STIs, including the potentially lethal ones like HIV, so it’s important to use one every time you have sex.