Let’s talk about sex (and STIs)

Published August 30, 2023

It’s important to prioritize your health and safety in all aspects of life—and sexual health is no exception. Whether you’re in a long-term relationship or enjoying the single life, it’s important to take the necessary precautions to protect yourself and your partner(s).

Sexually transmitted infections (STIs) are a serious global health threat. Over 1 million new STIs are reported every day—and an estimated 374 million new infections of chlamydia, gonorrhea, syphilis, and trichomoniasis occurred in 2020 alone. There are approximately 490 million people living with genital herpes, 300 million people affected by HPV infections, and 296 million people living with chronic hepatitis B.¹

The impact of STIs is immense and demands our attention.

What’s the difference between an STI and STD?

STI stands for sexually transmitted infection. STD stands for sexually transmitted disease. Both terms refer to infections that can be spread through sexual contact. But there’s technically a difference. 

An infection is when a harmful organism (virus, bacteria, or parasite) enters your body, and your immune system works to fight it off. A disease is when the infection causes symptoms, damages your body, and leads to an illness. 

The main difference is that an infection is the presence of a harmful organism, while a disease is the result of the infection. But not all infections develop into diseases. The term STI is used in this article because it covers all kinds of infections that can be passed through sexual contact—whether or not they cause symptoms.

What are the most common STIs?

There are dozens of STIs that can be passed from person to person through sex, but these are the 8 most common¹:

1. Chlamydia
2. Gonorrhea
3. Hepatitis B virus (HBV)
4. Herpes simplex virus (HSV)
5. Human immunodeficiency virus (HIV)
6. Human papillomavirus (HPV)
7. Syphilis
8. Trichomoniasis

How many people have an STI? How common are STIs?

Did you know that over 1 million STIs are contracted by people worldwide every single day?¹ But many people don't have any symptoms, making it easier for these infections to spread without anyone knowing.

In the United States, the CDC estimates that 1 in 5 people has an STI² and there are roughly: 

• Chlamydia: 1.6 million infections³
• Gonorrhea: 710,151 infections³
• HBV: 103,000 infections²
• HSV-2: 18.6 million infections²
• HIV: 984,000 infections²
• HPV: 42 million infections⁴
• Syphilis: 176,713 infections³
• Trichomoniasis: 2.6 million infections⁵

Are STI rates rising? Are we facing a global epidemic of STIs?

The global epidemic of STIs has been a concerning issue for years now, and hasn’t shown any signs of slowing down.¹ ᵃⁿᵈ ⁶ trend can be disheartening, but it’s not all doom and gloom. All of us can make a difference by staying vigilant, prioritizing our sexual health, and taking action to prevent, test for, and treat STIs.

Sexual health is important. It's something that often gets overlooked, but it's crucial that we prioritize it. One of the best ways to protect ourselves and our partners is through STI testing. STI testing might not be the most glamorous or exciting thing, but it's an incredibly important part of maintaining a healthy sex life. This is because many STIs don't show symptoms, which means that you or your partner could have an infection without even realizing it. By getting tested regularly, you can catch any potential infections before they have a chance to spread—and gain peace of mind in the meantime.

Who’s most at risk for an STI?

STIs can happen to anyone—no matter your age, gender, or sexual orientation. If you have oral, vaginal, or anal sex, you’re at risk for an STI. But some people are more at risk for STIs than others, including people who⁷:

• Have multiple sex partners
• Have sex with people who have multiple sex partners
• Have sex with anonymous partners
• Don't use condoms or protection
• Are under the influence of drugs or alcohol 
• Share drug injection equipment
• Have a weakened immune system or are HIV-positive

What’s bacterial vaginosis have to do with it? Is it an STI?

Bacterial vaginosis (BV) is a vaginal infection caused by an imbalance of the normal bacteria in the vagina. The vagina is normally home to a variety of bacteria, but when the levels of certain bacteria become too high, it can lead to BV.⁸ 

BV isn’t considered to be an STI, but it can increase the risk of getting one. Researchers don’t yet know how sex causes BV. But BV isn’t a stranger to many women and is the most common vaginal condition in women ages 15 to 44.⁸ 

BV doesn't always have symptoms, but when it does, you could notice⁸:

• A thin, white or gray vaginal discharge
• A fishy odor, especially after sex
• Pain, itching, or burning in the vagina
• Burning when urinating
• Itching around the outside of the vagina

Do people of all ages get STIs?

Yes, people of all ages can get STIs. But STIs are becoming more common among young people. In 2018, about half of the 26 million new cases of STIs affected people between 15 and 24 years old.⁹ 

During pregnancy and childbirth, it’s also possible for a pregnant person to spread an STI to their baby. Certain STIs can cross the placenta and infect the baby in the womb, while others can be spread as the baby makes its way through the birth canal. If you’re pregnant, it’s always best to talk with your healthcare provider about STIs and the risk of passing an STI to your baby during pregnancy, childbirth, or breastfeeding.¹⁰

What are the signs and symptoms of an STI?

It’s not always possible to know if you have an STI because many people don’t have symptoms. But some of the most common symptoms include:

• Burning while urinating
• Urinating often
• Itching or irritation of the vagina or penis
• Discharge from the vagina or penis
• Lower abdominal pain
• Pain during sex
• Unusual vaginal bleeding
• Pain in the scrotum or penis

There are many treatments for STIs and STDs. Testing is key and treatment should be started as early as possible.

Why should you get tested for an STI? How often should you get tested?

There are many reasons why STI testing is important. Here are the top 3:

1. To protect your health
2. To protect the health of others 
3. To know your status (testing is the only way to know for sure if you have an STI/STD)

How often to test (and which tests to get) might be different for each person. To help you out, here are some recommendations from the CDC⁷:

• Anyone 13 to 64 years of age should test at least once for HIV
• All sexually active women under 25 should test for gonorrhea and chlamydia every year
• All women 25 years and above with risk factors (multiple sex partners, partner with an STI) should test for gonorrhea and chlamydia every year
• Everyone who is pregnant should test for syphilis, HIV, HBV, and HCV early in pregnancy. People at risk for infection should also test for chlamydia and gonorrhea early in pregnancy. Repeat testing may be needed in some cases
• All sexually active gay, bisexual, and other men who have sex with men should test:
• At least once a year for syphilis, chlamydia, and gonorrhea (or more frequently)
• At least once a year for HIV (or more frequently)
• At least once a year for HCV if you’re living with HIV
• Anyone who engages in sexual behaviors that could put them at risk for infection should test for HIV at least once a year
• Anyone who shares drug injection equipment should test for HIV at least once a year
• Anyone who has oral or anal sex should talk with their healthcare provider about throat and rectal testing options

What are some common myths about STIs?

Let’s talk about (safer) sex. Sex is a natural and healthy part of life, but it can also come with risks. One of the risks is the spread of STIs. Unfortunately, the stigma surrounding STIs can prevent people from getting the care they need or even talking about their sexual health. It's time to break the silence and start having open and honest conversations about STIs.

Having an STI doesn't make you "dirty." It's an infection that can happen to anyone—no matter their sexual history or lifestyle. In fact, many people with STIs don't even know they have them, because some STIs don't have any symptoms.

Getting tested for STIs is an essential part of taking care of your sexual health. Some STIs can cause long-term health problems if left untreated. Yet, some people might not get tested because they feel ashamed or embarrassed. We need to shift the conversation around STI testing to emphasize the importance of taking care of ourselves and our partners—and that’s nothing to be ashamed of.

STIs can happen to anyone, but there are ways to protect yourself:

• Talk openly with your partner(s). This is important so that you can both make informed decisions about how to have safer sex, including using protection 
• Get tested for STIs (and your partner[s] too). This is the only way to know for sure if you have an STI
• If you do get an STI, get treated right away and talk with your partner(s) so they can get treated too. There are effective treatments available for most STIs

Remember, staying safe doesn't have to mean giving up on sex—it means being proactive by taking steps to protect yourself and others. 

What is HIV? What is AIDS?

HIV (human immunodeficiency virus) is a viral STI that attacks the body's immune system. If left untreated, it can lead to AIDS (acquired immunodeficiency syndrome). 

HIV is caused by 2 types of viruses called retroviruses:

1. HIV-1
2. HIV-2

Retroviruses are different than other viruses. They use ribonucleic acid (RNA) instead of deoxyribonucleic acid (DNA). But unlike most other viruses, retroviruses can't make their own proteins. Instead, they have to trick other cells into making their proteins for them.

To do this, retroviruses inject their RNA into a cell. The cell then reads the RNA and makes a copy of it in DNA. This DNA is then added into the cell's own DNA. This means that the virus becomes a permanent part of the host cell's genetic makeup. This allows the virus to make more copies of itself and continue to infect other cells with HIV.¹¹

How is HIV spread? How is it not spread?

HIV can spread from person to person through contact with HIV-infected semen, vaginal fluid, breast milk, or blood. Most people get HIV through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment. 

HIV needs a human host to survive. It can’t reproduce on its own. Because of this, HIV dies quickly outside the human body. It can't survive long on surfaces or in the air, so you can't catch HIV by shaking hands, touching, hugging, or using the same toilet as someone who has HIV. 

No doctor visit is required to buy your own lab test at questhealth.com. PWNHealth and its affiliates review your purchase to ensure it is medically appropriate before submitting the test order for processing. PWNHealth also reviews your test results and will contact you directly if they require prompt attention. Included in each purchase is the option to discuss your test results with an independent physician; however, you are also encouraged to speak with your primary healthcare provider. 

References

1. World Health Organization (WHO). Sexually transmitted infections (STIs). Accessed August 4, 2023. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis). 
2. Centers for Disease Control and Prevention (CDC). Sexually Transmitted Infections Prevalence, Incidence, and Cost Estimates in the United States. Accessed August 4, 2023. https://www.cdc.gov/std/statistics/prevalence-2020-at-a-glance.htm
3. Centers for Disease Control and Prevention (CDC). The State of STDs Infographic. Accessed August 4, 2023. https://www.cdc.gov/std/statistics/national.pdf. 
4. Centers for Disease Control and Prevention (CDC). HPV Infection. Accessed August 4, 2023. https://www.cdc.gov/hpv/parents/about-hpv.html 
5. Centers for Disease Control and Prevention (CDC). Trichomoniasis Statistics. Accessed August 4, 2023. https://www.cdc.gov/std/trichomonas/stats.htm. 
6. Centers for Disease Control and Prevention (CDC). U.S. STI Epidemic Showed No Signs of Slowing in 2021 – Cases Continued to Escalate. Accessed August 4, 2023. https://www.cdc.gov/media/releases/2023/s0411-sti.html. 
7. Centers for Disease Control and Prevention (CDC). Sexually Transmitted Diseases (STDs). Which STD Tests Should I Get? Accessed August 4, 2023. https://www.cdc.gov/std/prevention/screeningreccs.htm. 
8. Centers for Disease Control and Prevention (CDC). Bacterial Vaginosis. Accessed August 4, 2023. https://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm. 
9. Centers for Disease Control and Prevention (CDC). Sexually Transmitted Diseases (STDs). Adolescents and Young Adults. Accessed August 4, 2023. https://www.cdc.gov/std/life-stages-populations/adolescents-youngadults.htm. 
10. National Institutes of Health. Office of Research on Women’s Health. Maternal Morbidity & Mortality Web Portal. Sexually transmitted infections, pregnancy, and breastfeeding. Accessed August 4, 2023. https://orwh.od.nih.gov/research/maternal-morbidity-and-mortality/information-for-women/sexually-transmitted-infections.
11. Clinical Info HIV.gov. HIV/AIDS Glossary. Retroviruses. Accessed August 4, 2023. https://clinicalinfo.hiv.gov/en/glossary/retrovirus.