By KT Goyette
Art by Maanasi Shyno
So… To start with, what’s an STI? Good question, imaginary interlocutor! STI stands for Sexually Transmitted Infection. An STI is simply the entrance of a pathogen (bacterium, virus, parasite) entering into the body by sexual contact (genital-to-genital contact or genital-to-mouth contact).
How’s that different from an STD? STD stands for Sexually Transmitted Disease. If left untreated, an STI may (but not necessarily) develop into a disease. The pathogen begins to disrupt normal body processes, and one begins to show symptoms. “Disease” can sound a little pejorative at times, and one can have and pass on an infection without ever developing the disease, so public health experts often prefer the term “STI.” In casual conversation, however, “STI” and “STD” are essentially synonyms.[1]
Cool. I love terminology. As do I, friend.
Can you tell me some quick facts about these STIs, then? What causes them? What are their symptoms? How are they treated? How can I prevent them? Absolutely! FYI: A general rule of thumb for prevention is proper condom usage (every time, vaginal, anal, and oral!). Beyond the standard penile condom, there are also internal condoms (which are inserted into the vagina or anus), finger cots (also known as finger condoms, they’re exactly what you think from the name), and dental dams (placed between the mouth and vagina or anus). Another general rule of thumb: If you have multiple sexual partners, make sure both you and them are being regularly tested for STIs. These ideas are true for all STIs, so I won’t be noting them for each one.
If you’re concerned that you might have an STI, please see your doctor for further information. This document is a brief fact sheet, not comprehensive medical advice (which I am not qualified to give).
Chlamydia
Cause: The bacterium Chlamydia trachomatis, spread by sexual contact with the penis, vagina, anus, or mouth of an infected partner. Contact with ejaculate is not necessary. The bacterium can also be spread from parent to baby during childbirth.
Symptoms: Many people (the data is uncertain, but perhaps up to 90%) who are infected with chlamydia do not show symptoms. Of those who do, some may notice a burning sensation during urination, unusual vaginal discharge, penile discharge, and/or pain and swelling in the testicles. If the infection is rectal, symptoms include rectal pain, bleeding, and discharge.
Testing and Treatment: The most common ways to obtain a sample are vaginal swabs and urine collection. Chlamydia can be cured by antibiotics.[2]
Gonorrhea
Cause: The bacterium Neisseria gonorrhoeae, spread by sexual contact with the penis, vagina, anus, or mouth of an infected partner. Contact with ejaculate is not necessary. The bacterium can also be spread from parent to baby during childbirth. The bacterium can infect mucous membranes in the cervix, uterus, fallopian tubes, urethra, as well as the mouth, throat, eyes, and rectum.
Symptoms: Many people who are infected with gonorrhea do not show symptoms. Of those who do, symptoms include a burning sensation when urinating, increased vaginal discharge, bleeding between menstrual periods, white/yellow/green penile discharge, and/or pain or swelling in the testicles. If the infection is rectal, symptoms include anal discharge, itching, bleeding, and painful defecation. Infection in the throat may cause a sore throat.
Testing and Treatment: Samples for testing may be collected from urine, or swabs from the cervix, urethra, throat, or rectum. Gonorrhea can be cured with antibiotics. Resistant strains are emerging, however. If symptoms don’t abate, tell your doctor!
Genital Herpes
Cause: Genital herpes are caused by herpes simplex virus type 1 and herpes simplex virus type 2. (HSV-1 can also cause oral herpes). The viruses spread by contact with a herpes sore or nearby skin, saliva (if your partner has oral herpes), and/or genital secretions. The viruses can still be transmitted even if there are no visible sores.
Symptoms: Many people who are infected with genital herpes have no symptoms, or may mistake mild symptoms for other skin conditions. The primary symptom is blisters on and around the genitals, rectum, and mouth. These sores come and go in outbreaks. During the first outbreak, one might experience a fever and muscle aches.
Testing and Treatment: A doctor may simply look at the sores to diagnose herpes, or they may take a sample from a sore or from your blood. There is currently no cure for genital herpes. However, antiviral medications can decrease the intensity and frequency of outbreaks.
Prevention: If you have genital herpes, you can prevent (but not entirely eliminate!) the chance of passing the virus onto your partner by taking your antiviral medication and abstaining from sex during an outbreak.
Hepatitis
Cause: Hepatitis is caused by the hepatitis B and hepatitis D viruses. (Other hepatitis viruses are not spread sexually). The virus can be spread by sexual contact with an infected partner, contact with infected blood (such as through needle-sharing or accidental needle-sticks), or from parent to baby during childbirth.
Symptoms: Only about 30–50% of those infected (over the age of 5) show symptoms. These symptoms can include fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark urine, clay-colored stool, joint pain, and jaundice.
Testing and Treatment: Hepatitis can be confirmed by a blood test. For those with acute hepatitis, the symptoms are treated, but not the viral itself. Antiviral medications are available for chronic hepatitis B (about 5% of adults who contract hepatitis will be chronically infected). There is no specific treatment for the hepatitis D virus.
Prevention: There is a vaccine against the hepatitis B virus.
HIV/AIDS
Cause: The Human Immunodeficiency Virus (HIV) can be spread by sexual contact with the genitals or rectum of an infected person; from parent to child during pregnancy, childbirth, and lactation; and contact with infected blood (such as through needle-sharing or accidental needle-sticks). If the initial viral infection is not treated, the virus targets and destroys immune cells, eventually leading to Acquired Immunodeficiency Syndrome (AIDS).
Symptoms: During the acute phase of HIV infection, symptoms can include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymphs nodes, and mouth ulcers. Symptoms of AIDS vary greatly, as the weakened immune system is susceptible to a wide range of opportunistic infections.
Testing and Treatment: A doctor can test for the presence of HIV from a blood sample, or more rarely, a urine sample. At this time, there is no cure for HIV/AIDS. However, through antiretroviral medicines, you can decrease the level of HIV in your blood to undetectable levels. Once you start an antiretroviral medicine, it is imperative that you continue to take it for the rest of your life, or else the virus can rebound as a resistant strain! Opportunistic infections are treated on a case-by-case basis.
Prevention: If you are taking your antiretroviral medication regularly and your HIV levels are undetectable, there is almost no risk of passing the virus to a partner. If your partner has HIV and you do not, you can take a class of medicine called Pre-Exposure Prophylaxis to greatly reduce your chance of infection. If you have been unexpectedly exposed to HIV, you can start Post-Exposure Prophylaxis to prevent infection.
Human Papillomavirus
Cause: Human Papillomavirus (HPV) is actually a wide range of genetically-related viruses. These viruses can be spread by vaginal, anal, or oral sex with an infected partner.
Symptoms: Most of the time, HPV does not cause any symptoms or health problems, and most types of HPV are harmless. A small number can cause genital warts, and another small set (the two do not interact) can lead to cancers of the cervix, vulva, vagina, penis, anus, and throat.
Testing and Treatment: Currently, there is no cure for HPV, nor any standard test. One might learn they have had HPV after an abnormal Pap smear.
Prevention: There is a vaccine against cancer-causing HPV viruses.
Syphilis
Cause: Syphilis is caused by the bacterium Treponema pallidum, which is spread by contact with a syphilitic sore during vaginal, anal, and oral sex. The bacterium can also be transmitted from parent to child during pregnancy.
Symptoms: There are four stages of a syphilis infection, if left untreated. In the primary stage, sores arise where the bacterium initially entered the body. These sores are painless, and so often go unnoticed. In the secondary stage, symptoms include a rough, red, rash around the mouth, anus, or vagina, as well as fever, swollen lymph glands, sore throat, hair loss, headaches, weight loss, muscle aches, and fatigue. In the latent stage, symptoms disappear, sometimes for years. In the tertiary stage, the bacterium can infect a number of different organ systems (neurological, ocular, cardiovascular, hepatic, and/or skeletal), and symptoms vary accordingly.
Testing and Treatment: Syphilis is typically diagnosed by a blood test. It can be cured by antibiotics.
Trichomoniasis
Cause: Trichomoniasis is caused by the protozoan parasite Trichomonas vaginalis. The parasite can be spread by vaginal-penile contact. It is unlikely to spread to the mouth or the anus.
Symptoms: About 70% of people with trichomoniasis are asymptomatic. Of those who do show symptoms, symptoms include painful urination; itching, burning, redness, and soreness of the vagina and vulva; unusual vaginal discharge; penile discharge; and irritation inside the penis.
Testing and Treatment: A doctor can look for the parasite in a sample or urine or vaginal fluid. Trichomoniasis can be cured with antiparasitic medication.
Amazing! I feel so knowledgeable and prepared. If I’m on campus, what are some further resources I can access or places I can go? Dick’s House is a great first start. Regardless of insurance plan, they serve all on-term students.[3]There’s also a Planned Parenthood in WRJ (conveniently available by AT, on the orange line), which accepts most insurance, and, if you don’t have insurance, you may be eligible for sliding-scale payment.[4]
Any last words? Be safe, be smart, always use protection, and have fun!
[1] “STI vs. STD: Key Differences & Resources for College Students,” Tulane University School of Public Health and Tropical Medicine, accessed April 24, 2021, https://publichealth.tulane.edu/blog/sti-vs-std/.
[2] All information on STIs based upon “Sexually Transmitted Diseases (STDs),” Centers for Disease Control and Prevention, accessed April 24, 2021, https://www.cdc.gov/std/.
[3] “Reproductive & Sexual Health,” Dartmouth College Health Service, accessed April 24, 2021, https://students.dartmouth.edu/health-service/primary-care/health-wellness/health-information/reproductive-sexual-health.
[4] “White River Junction Health Center of White River Junction, VT,” Planned Parenthood, accessed April 24, 2021, https://www.plannedparenthood.org/health-center/vermont/white-river-junction/05001/white-river-junction-health-center-2745-91770.
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