Chances are you’ve heard some sketchy information on the subject of sexually transmitted infections. Rumors and myths about STIs are common. We don’t all have access to reliable sex education, and even accurate information can become outdated. But maybe, most of all, talking about STIs can feel weird. So, here. Read about them instead. Here are the answers to your most common questions about STIs.
1. What’s the difference between STIs and STDs?
STIs (sexually transmitted infections) and STDs (sexually transmitted diseases) are essentially different terms for the same thing: the bacteria, viruses, parasites, and other organisms that can infect people through oral, vaginal, and anal sex. STIs can be spread through bodily fluids such as semen, vaginal fluid, and blood, and via skin-to-skin contact.
Technically, “disease” implies that symptoms are present—which is often not the case with STIs. “Disease” may also feel more stigmatizing. Most sexual health educators working in colleges say “STIs.”
2. Which STI gets around the most? And how can I fend it off?
Human papillomavirus (HPV) is one of the most common STIs across all age groups. In the US, 79 million people have HPV, and more than 14 million people become infected every year, according to the Centers for Disease Control and Prevention (CDC). Most of the people who are infected are in their late teens and early 20s.
Nearly all sexually active men and women become infected with HPV at some point in their lives. Many strains of HPV don’t usually cause harm, but some strains of HPV can cause genital warts and cancers of the cervix, anus, penis, vulva, mouth, and throat.
- There’s a vaccine that protects against some strains of HPV—you can get it up to the age of 26 for women and 21 for men. You can also be vaccinated for hepatitis A and hepatitis B. Schedule a visit with your health care provider to get vaccinated.
- Use a condom and/or dental dam every time. These don’t guarantee protection but do reduce your risk.
- If you’re sexually active, get tested once a year or with every new sexual partner. Discuss the availability and accuracy of tests with your health care provider.
- Get comfortable talking about sex and STI prevention. This means:
- Feeling empowered to talk about what you want or don’t want sexually
- Discussing pleasure and what feels good to both of you
- Becoming comfortable with getting tested and asking partners to get tested as well
- Discussing the use of condoms (external and internal), lubrication, and dental dams (oral dams) to reduce exposure to STIs
- If unintended pregnancy is possible, discussing methods of birth control
3. Am I more likely to get accidentally pregnant or get an STI?
You’re twice as likely to get an STI as you are to get accidentally pregnant.
About one percent of college students said they or their partner experienced an unintended pregnancy in the last 12 months, according to the most recent data available from the National College Health Association survey. Just over two percent said they’d experienced an STI—and they are only the ones who knew about it (American College Health Association—National College Health Association survey, spring 2014).
By age 25, half of sexually active adults will have contracted an STI, according to the American Sexual Health Association.
4. What’s the difference between HPV and herpes?
Human papillomavirus (HPV) is often confused with herpes (herpes simplex virus, or HSV). These are two different viruses. They’re both transmitted through skin-to-skin contact.
HPV can cause genital warts and cancers of the cervix, anus, penis, vulva, mouth, and throat. Many strains of HPV don’t usually cause harm, however. Men up to age 21 and women up to age 26 can get a vaccine that protects against some strains of HPV. Talk to your health care provider.
Herpes can cause sores at the point of infection, which may be in the genital area or on the mouth. Many people who’ve been infected with herpes experience no symptoms or have mild symptoms that they attribute to other conditions. Treatment can help minimize the symptoms and lower the chance of transmission.
5. Which STIs should I get tested for?
Getting tested for STIs is a gateway to treatment and helps you protect yourself and your partner(s). Most tests are noninvasive and simple. Get tested for these conditions once a year or whenever you have a new sexual partner. Discuss with your health care provider whether to get tested for other STIs as well.
Medication can help minimize outbreaks but cannot cure herpes.
What’s the test like?
Testing usually involves a health care provider taking a swab of the affected area and/or a blood test.
These can be present without symptoms and can cause fertility problems in men and women if left untreated. Both are curable with antibiotics.
What are the tests like?
Usually a health care provider will ask for a urine sample or take a swab of the genital area.
One in six people in the US who have HIV don’t know it. If you’re at high risk of HIV, check out pre-exposure prophylaxis or PrEP. This medication can help reduce your risk.
What’s the test like?
A swab can be taken from the inside of the mouth, or a health care provider will take a blood sample.
Can cause severe complications such as brain damage or blindness if left untreated (usually after many years). It can be cured with antibiotics, but antibiotics can’t reverse any permanent damage caused by the disease. New cases are most common in men who have sex with men.
What’s the test like?
It usually involves a blood test or a sample taken from a sore.
6. How likely am I to get an STI?
By age 25, most US adults have acquired at least one STI. Teens and young adults are the most at-risk demographic for STIs. Nearly half of the 20 million new STI diagnoses each year are in people aged 15 to 24, according to the CDC.
Are STIs your fate?
No. To minimize your risk of becoming infected:
- Use a condom or dental dam every time.
- Get tested with every new sexual partner or once a year if you have the same partner.
- Get comfortable talking about sex and STI prevention.
Why are young adults at greater risk of STIs?
- Behavior (e.g., not using safer sex methods, having multiple sexual partners, and not getting tested). You can control behavioral risks.
- Culture (e.g., discomfort talking about sex and STI prevention, pressure to have sex, and expectations associated with gender roles). Being aware of these influences can help you address them.
- Biology. The physical development of young adults can make you more susceptible to STI infection. For example, in young women, the surface of the cervix is more exposed to some sexually transmitted organisms (e.g., HPV) than in older women.
7. What does an infection look like?
Often, an STI infection doesn’t look like anything. Most STIs don’t have visible symptoms. People who look perfectly healthy can be infected with STIs.
If you’ve ever looked at pictures of STI symptoms, be warned: In real life, symptoms often don’t look like those images. And most symptoms aren’t visible anyway.
Want to know if you or your partner has an infection? STI testing is the only way.
8. How can I talk to my partner about STIs?
What gives STIs their big advantage? Awkwardness. Talking about your sexual health allows you more protection, control, and autonomy. If you have an STI, it’s important to tell a partner before engaging in any sexual activity.
- Have the discussion in advance. Don’t wait until you’re caught up in the moment.
- Make the first move—a conversational move. Don’t wait for them to initiate the STI talk.
- Explain that this isn’t about trust and it’s not about cheating.
- If you’re anxious, acknowledge it: “OK, so this is awkward, but I’m pretty sure we can handle awkward. It’s important to me that we go get tested together.”
- If a partner tells you they have an STI, respect their honesty and maturity and their consideration for you and your needs. Protect their confidentiality.
- If you discuss this sensitively and yet your partner doesn’t want to get tested, be cautious. Healthy relationships require mutual respect and responsibility.
9. Does size matter? And other questions about condoms
Are students using condoms frequently?
Yes. Sixty percent of heterosexual sexually active students reported using a male condom for birth control the last time they had vaginal intercourse, according to the AMCH–NCHA survey (Fall 2017).
Can any other method help prevent both STIs and pregnancy?
No—only condoms (external and internal versions). Latex and latex-free (e.g., polyurethane) condoms are available. For oral sex involving a penis, you can use a dry, lubricated, or flavored condom. Putting lubrication inside the condom increases sensitivity for both partners and makes the condom easier to put on.
Does condom size matter?
Yes. The condom may stretch, but is it comfortable and pleasurable? Too tight, and the elastic base could cut off blood flow or cause discomfort. Too loose, and it could come off during sex. Condoms are available in varying shapes and sizes, so explore the best fit.
10. What’s a dental dam?
Dental dams (oral dams) probably lower your risk of STIs (but not pregnancy). A dental dam is a thin cover placed over the vulva or anus for oral sex. You can cut a condom or medical glove into a dental dam, or substitute plastic wrap. The effectiveness of dental dams (including plastic wrap) in preventing STI transmission has not been adequately studied; nevertheless, the use of dental dams is recommended by many sexual health professionals.
How can I get some?
Dental dams are available on many campuses for a low cost or for free. They’re also available in some specialty stores or online for about $1.50 each.
11. Which is more common: having a cat or having herpes?
It depends on which type of herpes we’re talking about. In the US, about 36 million people have a cat, according to the American Veterinary Medical Association (2012).
More people have a cat than have herpes type 2.
Herpes type 2 (HSV2) is traditionally known as genital herpes. In the US, one in six people aged 14–49 have genital herpes (CDC), and 776,000 new cases are diagnosed each year.
More people have herpes type 1 than have a cat.
Herpes type 1 (HSV1) causes cold sores and genital sores. In the US, Johns Hopkins University estimates that between 50 and 90 percent of adults have oral herpes. Although we think of HSV1 as causing cold sores, this strain of the virus can be transmitted through oral sex and is responsible for more cases of genital sores than HSV2 is.
Herpes is very common.
To reduce your risk of acquiring or passing on a herpes infection, use a condom or dental dam every time you’re sexually active.
Christine Sturgeon, community educator in sexual and reproductive health at the Sheldon M. Chumir Health Centre, Alberta.
Pierre-Paul Tellier, MD, director of student health services, McGill University, Montreal, Quebec.
American College Health Association. (2014). American College Health Association—National College Health Assessment (ACHA-NCHA) Reference Group Report, Spring 2014. Retrieved from https://www.acha-ncha.org/docs/ACHA-NCHA II_ReferenceGroup_DataReport_Spring2014.pdf
American Sexual Health Association. (2013). I wanna know. Retrieved from https://www.iwannaknow.org/teens/index.html
American Sexual Health Association. (2018). Statistics. Retrieved from https://www.ashasexualhealth.org/stdsstis/statistics/
American Veterinary Medical Association. (2012). US pet ownership statistics. Retrieved from https://www.avma.org/KB/Resources/Statistics/Pages/Market-research-statistics-US-pet-ownership.aspx
Bryant, K. D. (2009). Contraceptive use and attitudes among female college students. ABNF Journal, 20(1), 12–6.
Centers for Disease Control and Prevention. (2013, February). Incidence, prevalence, and cost and sexually transmitted infections in the US. Retrieved from https://www.cdc.gov/std/stats/sti-estimates-fact-sheet-feb-2013.pdf
It’s your sex life. (n.d.). MTV. [Website]. Retrieved from https://www.itsyoursexlife.com/
Johns Hopkins Medicine. (n.d.). Oral herpes. Retrieved from https://www.hopkinsmedicine.org/healthlibrary/conditions/adult/infectious_diseases/Oral_Herpes_22,OralHerpes
Satterwhite, C. L., Torrone, E., Meites, E., Dunne, E. F., et al. (2013). Sexually transmitted infections among US men and women: Prevalence and incidence estimates, 2008. Sexually Transmitted Disease, 40(3), 187–193.
Tampa, M., Sarbu, I., Matei, C., Benea, V., et al. (2014). Brief history of syphilis. Journal of Medicine and Life, 7(1), 4–10.