Sexually Transmitted Infections
What are sexually transmitted infections? — Sexually transmitted infections, often called STIs, are infections you can catch during sex. They are also called sexually transmitted diseases, or STDs. Some STIs are caused by bacteria, and others are caused by viruses.
The most common STIs include:
●Genital herpes, also called "herpes simplex virus" or "HSV"
●Genital warts, also called "human papillomavirus" or "HPV" – Some types of HPV can cause cervical cancer in women.
●Hepatitis A, B, and C
●Human immunodeficiency virus, also called "HIV" – This is the virus that causes AIDS.
Many of these infections can be transmitted through any type of sex. That includes not just penis-in-vagina or penis-in-anus sex, but also oral sex and other types of sex play. HIV and hepatitis can be transmitted in other ways, too, such as exposure to body fluids.
What is STI screening? — STI screening includes a series of tests that doctors use to find out if a person has any STIs. STIs often don't cause any symptoms. People can have STIs and not know it. That's what makes screening so important.
Doctors recommend that people who are at risk for STIs be screened even if they have no symptoms and feel fine. For example, you could be at risk for Chlamydia if you had unprotected sex with a new partner. Screening for Chlamydia will alert your doctor that you have this infection. Treatment will prevent the infection from getting worse and keep you from infecting other people.
There are different types of tests that screen for different infections. Many STIs can be found through a blood or urine test. If you decide to be screened for STIs, your doctor or nurse can work with you to figure out which specific tests you need.
Who should be screened for STIs? — Different screening tests are appropriate for different people, depending on their gender and sex habits.
●All men and women (including teenagers) should get screened for HIV.
●Women who have had sex without a condom or who have had sex with more than one partner should be screened every year for gonorrhea and chlamydia.
●Women ages 21 to 29 should have a Pap test every 3 years to screen for cervical cancer. Cervical cancer is caused by infection with some forms of HPV. Women ages 30 to 65 can continue having a Pap test every 3 years or they can switch to having a Pap test plus an HPV test every 5 years. Screening after age 65 depends on past test results.
●All men and women who are having sex and either do not have a stable partner or are having sex with more than one partner should get screened for hepatitis B.
●All men and women born between 1945 and 1965 should be screened for hepatitis C. Also, anyone who has had sex with a person infected with hepatitis C should be screened.
●Pregnant women should be screened for syphilis, chlamydia, HIV, and hepatitis B. Some pregnant women might also need to be screened for other infections depending on their sex habits.
●Men and women who are infected with HIV should be screened at least once for hepatitis A, B, and C. They should also be screened at least once a year for syphilis, chlamydia, and gonorrhea. Women who are infected with HIV should be screened at least once a year for trichomonas. Men who are infected with HIV, and who have sex with men with HIV, should be screened at least once a year for hepatitis C.
●Men who have sex with men should be screened at least once for hepatitis A, B, and C. They should also be screened at least once a year for HIV, syphilis, chlamydia, and gonorrhea.
The list above includes some general guidelines, but some people might need other screening tests depending on their sex habits and other factors. If you are unsure whether you should be screened and for what, ask your doctor or nurse for advice.
Where can I get screened? — If you have a doctor or nurse you see regularly, he or she should be able to screen you. But if you prefer to have screening done without your regular doctor or nurse, or if you don't have one, you can go to a clinic. To find a clinic near you, check with your local Department of Health or visit www.plannedparenthood.org. Some clinics let you get screened without giving your name (anonymously).
Be careful with any pharmacies or online stores that offer to sell you kits to use at home to screen for STIs. For some of these tests, you turn in or mail away a sample, and then you get the results either by phone or online. For others, you do a test at home and get results within an hour. But it is not always clear which test kits are ones you can trust. If you do use one of these kits and get a positive result, be sure to follow up with a doctor or nurse. And if you get a negative result but think you might have an infection, see a doctor or nurse.
What symptoms should I watch for? — In general, watch out for any genital itching, burning, sores, or discharge. But be aware that many STIs do not cause any symptoms. The best way to know for sure if you have an STI is to be screened.
What if I have an STI? — If you have an STI, you will need treatment. The right treatment will depend on the type of STI you have. Treatment might include antibiotics or medicines called antivirals, which fight viruses. Treatment will cure your infection or keep it from getting worse. It will also reduce the chances that you spread your infection to others.
If you do have an infection, you might need to tell the people you could have infected. Your doctor or nurse can help you figure out which partners you need to tell based on when you last had sex with them.
Can STIs be prevented? — There is no surefire way to prevent all STIs, but there are things you can do to reduce your chances of catching one.
●The most important thing you can do is to wear a condom every time you have sex. Both male and female condoms can protect against STIs. But be aware that male condoms made out of "natural materials," such as sheep intestine, do NOT protect against STIs.
●Ask your doctor if there are any vaccines you should have. If you are 26 years old or younger, you can get a vaccine to protect against HPV, the virus that causes genital warts. If you do not have hepatitis A or B and have not already gotten the vaccine for hepatitis A or B, you can get those vaccines, too.
●If your partner has herpes, he or she can reduce the chances of infecting you by taking a medicine called valacyclovir (brand name: Valtrex).
●If you are at very high risk of catching HIV, you might be able to take a pill every day to reduce the chances that you will get HIV. This is an option only for very few at-risk people. If you are interested in this, talk to your doctor.
Content adapted from UpToDate Patient Information.