What to know about sexually transmitted infections (STIs)

A growing spread of STIs is cause for concern. Here’s what to know about testing, treatment and prevention.

Sexually transmitted infections (STIs) aren’t something we talk about every day. Yet they’re a real health concern, with many types of infections on the rise. In a 2022 National Public Radio (NPR) interview, the executive director of the National Coalition of Sexually Transmitted Diseases (STDs) Directors called a current surge of cases “shocking,” saying that “it just seems to get worse and worse.” About 2.5 million combined cases of three of the more common STIs — chlamydia, gonorrhea and syphilis — were reported in 2021 alone.

Read on to understand what’s behind this trend and learn how to protect someone’s health through testing, treatment and prevention.

In this article:

STI screenings

STIs are most often transmitted through unprotected vaginal, oral or anal sex. But even if a person has been infected, they might not know it. Screenings are an important step to identify any infections, help patients receive the right treatment and help prevent further spread.

The Centers for Disease Control and Prevention (CDC) recommends different screenings based on age and sexual history. But they recommend that everyone between the ages of 13 and 64 get tested at least once for human immunodeficiency virus (HIV).

The CDC also recommends that all sexually active women younger than 25 get tested for gonorrhea and chlamydia every year. Check the CDC website for further guidance or speak with a health care provider about a plan.

How serious are STIs?

These kinds of infections, which sometimes exist in the body without noticeable symptoms, can cause serious, long-term health issues. It is estimated that 1.2 million people in the United States were living with diagnosed and undiagnosed HIV at the end of 2022. Without outward symptoms, many people don’t seek medical care and may pass the virus along to others.

“HIV is one of the most concerning STIs, because it’s a lifelong infection that can cause pretty severe immune problems,” says Jennifer Veltman, MD, chief of infectious diseases at California’s Loma Linda University Medical Center. Other STIs that “lie low” might also cause significant harm in the long run. A case of chlamydia can go unnoticed in a woman and lead to serious complications like pelvic inflammatory disease, which can cause infertility and ectopic pregnancy.

Common STIs

STIs are extremely common, and the CDC estimated that on any given day, one in five people in the United States were reported to have an STI in 2018. Human papillomavirus (HPV), chlamydia, genital herpes and trichomoniasis are some of the most common sexually transmitted infections, but there are over 20. Symptoms of STIs will depend on which one the person has. The good news is that nearly all STIs are either manageable or curable.

Lifelong STIs

STIs that may lead to a lifelong infection include these viral diseases:

• Genital herpes: This viral infection can be asymptomatic or can cause painful sores on or around the genitals, rectum, or mouth. It can be spread to others by having vaginal, anal, or oral sex with someone who has the infection during outbreaks. Herpes has no cure, but prescription antiviral medications are a common treatment to help manage genital herpes. These drugs can help prevent or shorten outbreaks.
• HIV and Acquired Immunodeficiency Syndrome (AIDS): HIV is a viral infection that attacks the body’s immune system. The first indication of an infection is often flu-like symptoms that can last a few days or weeks. If a person with HIV is diagnosed early and they get and stay on therapy as soon as possible, they can keep the virus suppressed and live a long and healthy life. With effective therapy, HIV is less likely to transition to AIDS, which can lead to serious infections, illness and death.
• HPV: HPV is a group of more than 200 types of viruses. HPV symptoms may include genital warts; however, many people don’t experience any symptoms. Women may learn they have HPV during a cervical cancer screening when they get an abnormal Papanicolaou (Pap) test result. In rare cases, the disease can lead to cancer. Thankfully, an effective vaccine against some of the high-risk subtypes is available and routinely recommended for all eligible people ages 11 to 26. However, other patients may be eligible based on individual risk factors to be discussed with their health care provider.

Curable STIs

• Chlamydia: This bacterial infection is easily cured; however, if untreated, chlamydia can cause pelvic inflammatory disease, which can cause infertility. Symptoms include pain when urinating and unusual discharge. The typical chlamydia cure is a course of antibiotics either as a single dose or over seven days.
• Gonorrhea: This bacterial infection can cause unusual discharge, sore throat (when spread through oral sex) and pain when urinating. Gonorrhea is curable but can cause serious health problems if left untreated. Complications can include infertility, increased risk of HIV and AIDS, and long-term pelvic or abdominal pain.
• Pubic lice: Also called crabs, these tiny insects lay eggs in pubic hair — but don’t cause many health problems, aside from itching around the genitals. Over-the-counter treatments, such as the CVS Health Lice Solution Kit, and prescription treatments are available.
• Syphilis: This bacterial infection causes sores typically around the genitals or mouth and can also cause rashes as the infection progresses. Without treatment, the infection can spread over time to the blood and cause problems in the brain, spinal cord, heart or other organs. Treatment of syphilis typically consists of one or more doses of benzathine penicillin G, depending on the stage of the infection.
• Trichomoniasis: Caused by a parasite, this infection can cause unusual discharge, itching of the genitals and pain when urinating or while having sex. However, only about 30 percent of those infected experience symptoms. Trichomoniasis or “trich” can increase the risk of getting or spreading other STIs, and pregnant people with trich are more likely to give birth prematurely.

Safer sex practices

Safer sex helps prevent the spread of STIs. One easy measure? “I always recommend condoms,” says Casey Pinto, PhD, an assistant professor in the Department of Public Health Sciences’ Division of Epidemiology at Pennsylvania State University.

There are many condom options to suit different preferences, including SKYN Elite Non-Latex Condom, Trojan BareSkin Raw Lubricated Latex Condoms and Durex Extra Sensitive Lubricated Ultra Thin Premium Condoms.  Dental dams (thin, flexible pieces of latex or polyurethane) can also offer protection during oral sex. These barriers, when used consistently and correctly, help reduce the risk of STI transmission, especially those that are spread by bodily fluids.

At-home STI tests

Condoms and dental dams aren’t foolproof, so it’s important to get tested for STIs before starting a monogamous relationship. “The key is to get tested frequently to catch STIs early,” says Dr. Veltman. The earlier most STIs are diagnosed and treatment is started, the better the health outcomes for patients.

Luckily, there are many testing options. A person can get checked during their annual wellness visit or pelvic exam or get an STI evaluation at a walk-in clinic. They can also take an at-home test. The CVS Health Common STI Test Kit and OraQuick In-Home Test Kit,  for example, check for HIV in the comfort of someone’s home. Some at-home tests require the sample to be sent to a laboratory, so make sure to closely follow their directions. Some state health departments offer free at-home STI tests as well.

When to see a doctor for STI treatment

If someone has been diagnosed with an STI from a home test, or if they notice any STI symptoms, they should visit a health care provider. Symptoms may include the following:

• Unusual discharge from the penis or vagina
• Genital itching and redness
• Warts or genital sores
• Frequent or painful urination
• Blisters or sores in or around the mouth
• Abnormal vaginal odor
• Anal soreness, itching or bleeding

A health care provider may prescribe antibiotics to treat STIs caused by bacteria or parasites, such as gonorrhea, syphilis, chlamydia and trichomoniasis. While STIs caused by viruses can’t be cured, medications can help manage symptoms and lower the risk of spreading the infection.