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Sexually Transmitted Infections
What are STIs?
An sexually transmitted infection (STI) is an infection transmitted through sexual contact, caused by bacteria, viruses, or parasites. More than 30 different bacteria, viruses and parasites are known to be transmitted through sexual contact, including vaginal, anal and oral sex. Some STIs can also be transmitted from mother-to-child during pregnancy, childbirth and breastfeeding.
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What are some common STIs?
Chlamydia
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A common sexually transmitted infection that may not cause symptoms
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Symptoms
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Painful urination, vaginal discharge, discharge from the penis, painful vaginal sex, vaginal bleeding between periods and after sex, testicular pain
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Testing/diagnosis
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Chlamydia is diagnosed with with nucleic acid amplification tests (NAATs), cell culture, and other types of tests
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NAATs are the most sensitive tests to use on easy-to-obtain specimens
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This includes vaginal swabs or urine
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Treatment
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Chlamydia can usually be treated easily with antibiotics
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You may be given a course of doxycycline to take for a week or azithromycin to take once a day for 3 days
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If you have doxycycline, you should not have sex (including oral sex) until you and your current sexual partner have finished treatment
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Gonorrhoea
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A sexually transmitted bacterial infection that, if untreated, may cause infertility
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Symptoms
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Discharge, burning during urination, unusual sores, or rash
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Testing/diagnosis
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A urine sample is used to diagnose gonorrhea
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If you have had oral and/or anal sex, your healthcare provider may use swabs to collect samples from your throat and/or rectum
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Treatment
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An individual with gonorrhea is treated with antibiotics
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Uncomplicated gonorrhea can be treated with the antibiotic ceftriaxone
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Herpes simplex virus (HSV)
Hepatitis B
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A serious liver infection caused by the hepatitis B virus that's easily preventable by a vaccine
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Symptoms
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Abdominal pain, dark urine, fever, joint pain, loss of appetite, nausea and vomiting, weakness and fatigue, yellowing of the skin and the whites of the eyes (also called jaundice)
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Testing/diagnosis
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Blood tests can help diagnose hepatitis B
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Blood tests can detect signs of the hepatitis B virus in your body and tell your provider whether it's acute or chronic
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A simple blood test can also determine if you're immune to the condition
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Treatment
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Treatment for chronic hepatitis B may include antiviral medications
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Several antiviral medicines can help fight the virus and slow its ability to damage your liver
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A virus causing contagious sores, most often around the mouth or on the genitals
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Symptoms
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Common oral herpes symptoms include blisters (cold sores) or open sores (ulcers) in or around the mouth or lips
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Common genital herpes symptoms include bumps, blisters, or open sores (ulcers) around the genitals or anus
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Testing/diagnosis
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The virus is collected from lesions on skin or genitals by swabbing or scraping with a scalpel
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Treatment
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There is no cure for genital herpes
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However, daily use of antiviral medicines can prevent or shorten outbreaks
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Antiviral medicines also can reduce the chance of spreading it to others
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HIV
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A virus that attacks the body's immune system
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Symptoms
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Fever and muscle pains, headache, sore throat, night sweats, mouth sores, including yeast infection (thrush), swollen lymph glands, diarrhea
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Testing/diagnosis
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Antigen/antibody tests are recommended for testing done in labs and are common in the United States
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An antigen/antibody test performed by a lab on blood from a vein can usually detect HIV 18 to 45 days after exposure
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There is also a rapid antigen/antibody test available that is done with a finger stick
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Treatment
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HIV treatment involves taking medicine as prescribed by a health care provider
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HIV treatment reduces the amount of HIV in your body and helps you stay healthy
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There is no cure for HIV, but you can control it with HIV treatment
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Most people can get the virus under control within six months
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HIV treatment does not prevent transmission of other sexually transmitted diseases
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Human papillomavirus (HPV)
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An infection that causes warts in various parts of the body, depending on the strain
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Symptoms
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Genital warts, common warts, plantar warts, flat warts
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Testing/diagnosis
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Your doctor might be able to diagnose human papillomavirus (HPV) infection by looking at your warts
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If genital warts aren't visible, you'll need to take a test
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Vinegar (acetic acid) solution test
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A vinegar solution applied to HPV and infected genital areas turns them white
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Treatment
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There is no treatment for the virus itself
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However, there are treatments for the health problems that HPV can cause
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Genital warts can be treated by your healthcare provider or with prescription medication
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If left untreated, genital warts may go away, stay the same, or grow in size or number
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Syphilis
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A bacterial infection usually spread by sexual contact that starts as a painless sore
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Symptoms
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Fever, swollen lymph nodes, sore throat, patchy hair loss, headaches, weight loss, muscle aches, fatigue
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Testing/diagnosis
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Usually a blood test
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A health care professional will take a blood sample from a vein in your arm using a small needle
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A small amount of blood will be collected into a test tube or vial
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Treatment
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A single injection of long-acting Benzathine penicillin G can cure the early stages of syphilis
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Trichomoniasis
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A sexually transmitted infection caused by a parasite
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Symptoms
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Itching, burning, redness or soreness of the genitals, discomfort when peeing, a clear, white, yellowish, or greenish vaginal discharge (i.e., thin discharge or increased volume)
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Testing/diagnosis
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Testing is done through a swab from either the vagina or penis
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The swab will be analyzed in a laboratory to check for signs of the infection
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In men, a urine sample can also be tested for trichomoniasis
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Treatment
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Trichomoniasis is usually treated quickly and easily with antibiotics
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Most people are prescribed an antibiotic called metronidazole
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You'll usually have to take metronidazole twice a day, for 5 to 7 days
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What is the difference between STIs and STDs?
STD stands for “sexually transmitted disease,” and STI stands for “sexually transmitted infection.” However, they're talking about the same thing: infections that get passed from one person to another during sex.
Data, statistics, and research
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During 2021 to 2022 the rate of P&S syphilis increased 17.2% among women aged 15-44 years
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More than 9 million women in the United States are diagnosed with an STI each year
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Women often experience complications from STIs, including infertility and chronic pelvic pain, that can have lifelong impact
Sexually transmitted infections and female reproductive health
Olivia T. Van Gerwen , Christina A. Muzny, and Jeanne M. Marrazzo, Reprod Biomed Soc Online. 2022
In this article the National Library of Medicine highlights the disproportionate impact of sexually transmitted infections (STIs) on women compared to men. Various factors including the higher efficiency of male-to-female transmission and biological differences in the female reproductive tract impact this difference. Social and structural barriers further hinder women's access to comprehensive sexual healthcare, including limited availability of HPV immunization, barriers to contraception access, and lack of confidential evaluation and counseling services. Additionally, women often face financial and social constraints, limiting their access to resources essential for sexual safety and health. While ensuring access to diagnostics and therapies is crucial, addressing these broader systemic issues is also essential.
Case Studies
“I would never have consented if I would have known... I feel that my rights were violated.”
STIs, especially incurable ones, can raise issues of consent, or what is sometimes called “informed consent.” In many countries it is illegal to knowingly infect a person with HIV. In other places, lawsuits have been brought against individuals who have engaged in unprotected sexual contact, knowing they have a transmissible STI, without informing their partner(s). One famous example is that of singer Usher, who was sued by three fans in 2017 for knowingly infecting them with genital herpes. Usher has also not denied media reports that he paid a woman a $1.1-million settlement in 2012 after he transmitted herpes to her following unprotected sexual contact.