April is STI Awareness Month-Kayla Matteo, Des Moines University Student Doctor
My high school sex ed class can be summed up as playing “toss the testicle” with rubber body organs. Sexual health was an awkward topic that my well-meaning health teacher seamlessly avoided — in hindsight, many would have had a difficult time rallying a class of 15-year-olds who could barely keep it together at any mention of “vagina.” One would assume that my college education would make up for the experience of only learning how to throw a curveball with a rubber testicle, but I never fully received that knowledge. Sure, we had some optional talks at the club fair's Planned Parenthood booth, but many other college students and I moved through our teenage and early adult years without foundational knowledge about sex, and the reality of the not-so-fun additions to sex: sexually transmitted infections.
Now I find myself here in medical school, finally learning the hard facts of STI prevention that I never fully picked up in all my 20 years of education. April is STI Awareness Month, and I am determined to ensure that knowledge about STIs and how to prevent them CANNOT only be reserved for medical students. Adolescents need to be armed with such knowledge to protect themselves and others, and have confidence in advocating for their own bodies and health when the time comes. So here are some common facts and myths about STIs that I wish I knew back then during health class, and what we need others to know now.
· Fact vs myth: Syphilis is an STI that was only prominent during the 1400s-early 1900s.
o MYTH: In fact, right here in Iowa, there has been a huge rise in syphilis cases based on data from 20211. So how do we protect ourselves from contracting syphilis? The only way to protect yourself from syphilis is to use condoms to prevent contact with sores. However, some syphilis sores are not fully covered by condoms, and syphilis can be contracted by contacting these sores 2. The best thing to do is use condoms, and stay aware! If you’re unsure where to get condoms, don’t feel comfortable buying them, or cannot afford them, here is a condom locator that shows places to get free condoms!
· Fact vs myth: There is a cure for syphilis.
o FACT: A single injection of Penicillin G can cure the earlier stages of syphilis2. If you need to be treated for syphilis, wait until the sores are completely healed before having sex again, and tell your partner so they can get treatment too!
· Fact vs myth: You can give someone genital herpes if you perform oral sex on them with an active cold sore.
o FACT: Oral herpes is usually caused by HSV-1 and genital herpes is usually caused by HSV-2. While these two strains of herpes prefer to hang out in different locations, they can sometimes change teams when exposed to the other location. If someone performs oral sex while having an active cold sore (aka an HSV-1 infection), it is possible for HSV-1 to pop up on the genitals. If someone has an active HSV-2 infection on the genitals, it is possible for HSV-2 to show up around the mouth 3,4.
· Fact vs myth: You can only give someone genital herpes with an active, symptomatic infection.
o MYTH: People can still spread herpes infections without any symptoms due to “viral shedding.” In fact, most people are infected with herpes during this asymptomatic shedding period5. Therefore, it is extremely important to keep barrier methods like condoms and dental dams in your back pocket (or wallet, whichever you prefer)!
· Fact vs myth: If you don’t have any symptoms, you don’t have an STI.
o MYTH: There are several STIs that can be asymptomatic, so it’s important to get tested when you are sexually active. Untreated STIs can cause infertility, chronic health problems, and more. Here are some of the most common asymptomatic STIs and possible health risks if they are left untreated, and how to prevent them 6,7.
STI: HPV (Human Papillomavirus)
Risks If Untreated- Cervical cancer (and others)
How to Prevent If Sexually Active-
GET VACCINATED!
Routine cervical cancer screening
Condoms
Monogamy
Getting tested before and after each new partner
2. STI: Chlamydia & Gonorrhea
Risks If Untreated- Pelvic Inflammatory Disease (scarring of fallopian tubes), which can lead to infertility
How to Prevent If Sexually Active-
Condoms
Monogamy
Getting tested before and after each new partner
3. STI: Trichomoniasis
Risks if Untreated: Increased risk of getting other STIs and HIV
How to Prevent if SexuallyActive:
Condoms
Monogamy
Getting tested before and after each new partner
4. STI: Herpes
Risks if Untreated: Spreading to sexual partners
How to Prevent if Sexually Active:
Condoms
Monogamy
Getting tested before and after each new partner
*Keep in mind that while condoms are the most effective form of STI prevention other than abstinence, they are not 100% protective. Even though the risks are low, you could be doing everything right and still might contract an STI.
Fact vs Myth: Having a sexual relationship is not possible if I contract an STI.
o MYTH: There is a ton of shame and stigma associated with contracting an STI, which can often make people feel like sex in the future is out of the question. However, not only are STIs quite common, most of them are extremely manageable. For example, chlamydia, gonorrhea, and syphilis can be treated with a course of antibiotics. Herpes and HIV may be incurable, but their infectiousness can be significantly lowered with antiviral medications. It may be difficult to tell your partner about your STI status, but letting your partner know before you have sex allows both of you to make informed choices about having sex. Open and honest communication creates a safe environment for you and your partner to decide how to proceed8.
Talking about STIs can often be uncomfortable, but arming yourself with the knowledge early on can make all the difference when it comes to prevention. To learn more about STIs and how to prevent them, chat with a trusted healthcare provider — they’ve got your back.
Sources
1. Iowa Public Health Tracking Portal, Syphilis Data, 2021. https://tracking.idph.iowa.gov/Health/Sexually-Transmitted-Diseases/Syphilis-Data
2. Center for Disease Control and Prevention. Syphilis & MSM Fact Sheet, 2022. https://www.cdc.gov/std/syphilis/stdfact-msm-syphilis.htm#:~:text=Using%20latex%20condoms%20the%20right,sores%20can%20still%20transmit%20syphilis
3. Center for Disease Control and Prevention. Genital Herpes Fact Sheet, 2022. https://www.cdc.gov/std/herpes/stdfact-herpes.htm#:~:text=Yes.,are%20due%20to%20HSV%2D1
4. Planned Parenthood. Oral & Genital Herpes. https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/herpes
5. Mount Sinai Health Library. Herpes simplex. https://www.mountsinai.org/health-library/report/herpes-simplex#:~:text=Genital%20herpes%20is%20contagious%20from,not%20present%20(asymptomatic%20shedding)
6. Michael Cackovic, MD. Ohio State University Wexner Medical Center. STIs you can have with no symptoms, 2019. https://wexnermedical.osu.edu/blog/stis-without-symptoms
7. Center for Disease Control and Prevention. Sexually Transmitted Infections Fact Sheets. https://www.cdc.gov/std/healthcomm/fact_sheets.htm
8. Center for Disease Control and Prevention. STI Awareness Week: Conversation Tips, 2022. https://www.cdc.gov/std/saw/pbyt/conversation.htm