Overview
Sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) are usually acquired through sexual contact. The organisms (viruses, bacteria, or parasites) that cause STIs may pass from person to person in semen, vaginal fluids, blood, or other bodily fluids.
There are circumstances in which these infection are transmitted nonsexually, such as through blood transfusions, through pregnancy or breastfeeding, or through shared needles.
STIs don’t always cause symptoms. It is possible to contract a sexually transmitted infection from people who seem healthy and may not know that they are infected.
Symptoms
STIs have a wide range of symptoms and signs including none at all. That’s why they may go unnoticed until a partner is diagnosed or until you notice complications. Signs and symptoms of STIs include:
- Painful or burning urination
- Unusual vaginal bleeding
- Sores or bumps on the oral or rectal area or on the genitals
- Unusual or odd-smelling vaginal discharge
- Pain during sex
- Discharge from the penis
- Lower abdominal pain
- Sore, swollen lymph nodes, usually in the groin but sometimes more spread out
- Rash over the hands, trunk, or feet
- Fever
Symptoms can start appearing a few days after exposure, or they can take years to present themselves depending on the organism.
Causes
STIs may be caused by:
- Parasites (trichomoniasis)
- Bacteria (syphilis, gonorrhea, chlamydia)
- Viruses (genital herpes, human papillomavirus, HIV)
Sexual activity has a role in the spread of many other kinds of infections. It is, however, possible to become infected without sexual contact. Examples include shigella, hepatitis A, B, and C, and Giardia intestinalis.
Diagnosis
Tests
If your symptoms and sexual history suggest you may have an STI, laboratory tests can identify the cause and also detect coinfections. Your doctor may order any of the following tests:
- Urine samples. Some STIs can be confirmed through a urine sample
- Blood tests. Blood tests are able to confirm the diagnosis of later stages of syphilis as well as HIV
- Fluid samples. If you have open genital sores your doctor might test samples and fluid from the sores to diagnose the type of infection
Screening
Testing for a disease in someone who exhibits no symptoms is called screening. Most of the time, STI screening is not a routine part of most people’s health care, but there are groups who it is recommended have screenings:
- Everyone. There is one STI screening test suggested for people 13-64. It is a blood or saliva test to check for HIV, the virus that causes AIDS. Experts recommend that people in high risk groups have an HIV test yearly.
- Anyone born between 1945-1965. There’s a high incidence of hepatitis C in the group of people born between 1945 and 1965. Since the disease usually causes no symptoms until it’s in advanced stages. Experts recommend anyone in that age group to be screened for hepatitis C.
- Pregnant women. At their first prenatal visit those who are pregnant will usually get screened for hepatitis B, HIV, syphilis, and chlamydia. Hepatitis C and gonorrhea screenings are also recommended at least once during pregnancy for those with a high risk of infection.
- Women age 21 and older. The Pap test screens for cervical abnormalities. These abnormalities may include: precancerous changes, inflammation, and cancer which could be caused by some strains of the human papillomavirus (HPV). Experts recommend that women over the age of 21 have a Pap test every three years. After the age of 30, it is recommended to have a Pap smear every 5 years.
- Women under the age of 25 who are sexually active. Experts advise that all sexually active women under 25 should be tested for chlamydia. The chlamydia test uses a sample of vaginal fluid or urine that you collect yourself. If you’ve had a positive test and have been treated for chlamydia some doctors recommend another screening 3 months after your STI treatment.
- The Queer Community. Compared with other groups, the LGBTQ+ community has a higher risk of acquiring STIs. Many public health groups advice annual or more-frequent STI screening. Regular tests for syphilis, HIV, gonorrhea and chlamydia are particularly important. Evaluations for hepatitis B are also advised.
- People with HIV. If you have HIV, it greatly increases your risk of contracting other STIs. Experts advise immediate testing for gonorrhea, syphilis, herpes, and chlamydia after getting a positive HIV diagnosis. They also recommend that those with HIV be tested for hepatitis C and have a Pap test.
- People with a new partner. Before having penetrative sex with new partners, both parties should be tested for STIs. However, unless you have symptoms, you don’t need to get a routine test for genital herpes. It is also possible to have an STI and still test negative, particularly if you’ve been infected recently.
Treatment
Sexually transmitted infections caused by bacteria are easier to treat. Viral infections can be managed but are not always curable. If you’re pregnant and infected, getting STI treatment immediately can reduce the risk of or prevent the baby from becoming infected.
STI treatment usually consists of one of the following, depending on the infection:
- Antiviral drugs. If you have HIV or herpes, you’ll be prescribed an antiviral drug. You’ll have fewer recurrences of herpes if you take daily suppressive therapy with a prescription antiviral drug. However, even with these STI treatments you can still pass herpes to a partner.
Antiviral drugs are a critical part of STI treatment for HIV and can keep the infection in check for many years. You will still carry the virus and transmit it even though the risk is lower. The sooner you start treatment for HIV, the more effective it is. If you take your medicines exactly as directed it’s possible to reduce your virus count to undetectable status. Medication for herpes includes Valtrex (Valacyclovir) and Zovirax Ointment. - Antibiotics. Antibiotics, usually in a single dose, can cure many bacterial and parasitic infections. This STI treatment usually works for syphilis, trichomoniasis, gonorrhea, and chlamydia. Typically you’ll be treated for chlamydia and gonorrhea at the same time because those two infections will often appear together.
Once you start STI treatment with antibiotics you have to follow through. If you don’t think you can take the medication as prescribed talk to your doctor. A shorter, simpler course may be available. It is also crucial to abstain from sex until 7 days after completing antibiotic treatment and any sores have healed. Medications for chlamydia include: Zithromax, Eryc, and levofloxacin.
If you’ve had STI treatment, ask your doctor how long after your treatment you have to be retested. Getting retested will make sure that the treatment was effective and that you haven’t gotten reinfected.
Partner notification and preventive treatment
If tests show that you have an STI, your sexual partners (including partners you’ve had over the past 3 months to a year as well as your current partner) need to be told so that they can get tested. If they’re infected they can then get STI treatment.
Each state has different requirements, but many states require that certain STIs be reported to the local or state health department. Public health departments will employ trained disease intervention specialists who can help to notify partners and refer individuals for STI treatment.
Official, confidential partner notification helps to limit the spread of STIs, particularly for HIV and syphilis. This practice also steers people at risk towards counselling and the right STI treatment. Since you can contract some STIs more than once, notifying your partners reduces your risk of getting reinfected.
