STDs, STIs, and Staying Safe During Intimacy
Kristy Goodman
Kristy Goodman is the Co-Founder and CEO of PreConception Inc., an online service that provides direct-to-consumer preconception testing for women who are planning a pregnancy. Kristy is a women’s health PA with an M.S. in PA Studies and an MPH in Health Education and Behavioral Science from the University of Medicine and Dentistry of New Jersey. Kristy completed a postgraduate fellowship in Ob/Gyn and has worked in a variety of settings including sexual health, obstetrics, and infertility evaluation and treatment. Kristy lives in Los Angeles, California, and can be found on Instagram @theobgynpa.
Est. Time: 12 mins
Get expert insight and advice on today’s most common STDs and STIs, learn the warning signs, and read what it really takes to stay safe while intimate.
You’re probably familiar with some of them (chlamydia, HIV), and you might know the basics when it comes to safe sex. And if you’re one of the more than 100 million Americans who have an STI, you’ve learned a lot since being infected. But even those who know a thing or two can run into information that sounds good on the surface, but is actually misleading or downright false.
With STDs and STIs, the consequences can be permanent. Some may be temporary and require a round of antibiotics to clear up, but others remain with you for life, and can put that very life in jeopardy. If you’re sexually active, no matter your age, gender, or orientation, this guide is here to help. Get detailed information on some of today’s most common intimacy-related viruses and infections, and read expert advice on how to really stay safe, where to go to get tested, and what to do if your results come back positive.
Today’s Most Common STDs and STIs
With several STDs and STIs on the rise, you need to know what to look for. And because it’s not always clear (symptoms can be tricky to identify), you need to get tested. But getting tested doesn’t mean visiting your general practitioner and taking a one-test-for-all that covers everything from gonorrhea to HPV. You need to be specific.
“It’s incredibly important to understand which STIs you’re being tested for and which STIs you’re not,” said Kristy Goodman, Co-Founder and CEO of PreConception Inc. “Studies have shown that the majority of patients cannot accurately identify which STIs they’ve been tested for and which they have not, so asking your healthcare provider to tell you, and requesting any specific tests that you want, is super important.”
Here are the most common STDs and STIs today:
Chlamydia
Chlamydia is a bacterial infection that can affect several parts of men’s and women’s bodies, including the vagina, penis, cervix, and anus. It is generally treated with antibiotics.
Genital Warts
Genital warts are growths that can be found in the genital and anal areas. This STD is caused by the human papillomavirus and, in serious cases, can result in cervical cancer.
Gonorrhea
This condition, also known as the clap or the drip, is a bacterial infection that can appear in warm, moist areas of the body like the anus, throat, and vagina. This STD is particularly common among teenagers and people in their twenties
Hepatitis B
Hepatitis B is a sexually transmitted disease that infects the liver. In extreme cases, this condition can cause liver failure, cirrhosis, or liver cancer.
Herpes
Caused by the herpes simplex virus, this STD can lead to sores on the genital or anal areas, as well as the mouth. Although this is a long-term condition that generally results in regular flare-ups, there are medications available that can help manage the symptoms.
HIV and AIDS
The human immunodeficiency virus (HIV) is the virus that leads to AIDS. This condition attacks white blood cells in the body, which lowers people’s immune system and makes them highly susceptible to other illnesses.
HPV
HPV, or human papillomavirus, is an STD that generally goes away on its own and does not cause long-term damage to the body. However, in extreme cases, people can develop cancer or genital warts from the virus.
Syphilis
Syphilis is a bacterial infection that can be treated with antibiotics if it is caught in the early stages. However, those who are not treated can develop serious health problems, including heart disease, blindness, and damage to the nervous system.
Trichomoniasis
Trichomoniasis, which is also known as trich, is caused by a parasite that is transferred from one person to another through vaginal contact. While men who contract this STD tend not to have any symptoms, women may experience painful urination or vaginal discharge with an unpleasant smell.
Who is at Risk?
An STD does not discriminate, so anyone who is sexually active is at risk for contracting one. According to the CDC, there were 241,074 cases of gonorrhea in 2018 among women, while the cases of the STD doubled among gay and bisexual men in recent years—making these two groups the most likely to contract it. Similarly, chlamydia is the most reported STD among women, especially those in the 15 to 24 age group, though men saw a 40 percent increase in cases between 2013 and 2017.
Warning Signs
People who are sexually active should know the warning signs of an STD so they can be tested as soon as those symptoms appear. Some of the most common symptoms that people may experience include:
- A burning sensation when urinating
- Bumps and sores on the mouth and genitals
- Vaginal odor
- Soreness of the anal area
- Painful intercourse
- Fever
- Rash on hands, feet, and chest
- Vaginal bleeding
- Severe genital itching
- Jaundice
Although these warning signs can be a helpful indicator of having an STD, it’s important for people to remember that some illnesses don’t cause visible symptoms. As a result, asymptomatic people should still be tested because those who don’t know they have a condition can suffer permanent damage if the STD isn’t caught in time.
“STIs that go untreated can lead to major and long-term health complications—infertility, pelvic inflammatory disease, and even cancer. Don’t be fooled, just because you don’t feel any different,” said Dr. Jordin Wiggins, author of The Pink Canary. “For example, approximately 75 percent of women and 50 percent of men have zero symptoms but test positive for chlamydia. These STIs can lie dormant for years without symptoms, so the only way to know for sure is to get tested.”
How and Where to Get Tested for STDs
It is important for all people who are sexually active to get tested for STDs. This is especially true if they exhibit any of the signs. The following section details where you can get an STD test and what you can expect when you do.
Where to Get Tested
Planned Parenthood health centers provide testing for a variety of STDs, including herpes, chlamydia, gonorrhea, syphilis, and trichomoniasis. The organization also provides treatment to those who test positive for these illnesses, as well as education on how to prevent them to those who don’t.
People who have a long-time relationship with a physician may feel more comfortable being tested at their doctor’s office. Not only is this option convenient, but it can also be helpful because someone’s regular doctor has access to their medical history, which facilitates the best treatment decisions.
Students are able to be tested for STDs at their school’s student health center. The available tests offered may vary depending on the school, but in some cases, they may be able to request specific tests or receive guidance on which ones they should have done.
Sometimes community clinics organize events so people can get tested during a specific time period. In other cases, these organizations offer regular hours to receive testing or allow people to make an appointment.
County health departments offer STD screenings as part of their wellness programs, as well as treatment and prevention education.
What Happens When You Get Tested?
STEP 1
Make an appointment and ask for the test
People who have a regular doctor, as well as those going to the college health center, can call to make an appointment for an STD test. Those who are getting tests from a county health department or community clinic may need to have their testing done during specific days and times designated for STD screenings.
STEP 2
Keep Your Appointment
In order to get the right tests, people should talk to their doctor about what their concerns are. Doctors will ask questions about symptoms, sexual history, intimate activities that are being engaged in, and any other behaviors that may increase their risk of contracting an STD.
After people provide the information necessary to determine which tests should be taken, the doctor will perform a physical examination and collect samples—such as blood and urine, as well as swabs taken from the mouth, anus, or genital area.
The cost of an STD test depends on where people get them. Places like community clinics and Planned Parenthood may offer free or low cost testing, which can be less than $50. At colleges and universities, as well as doctor’s offices, STD testing may be covered by insurance.
STEP 3
Wait for results
People generally get the results of an STD test within one week. The doctor will call patients to tell them what the results are, or in some cases, send an email or text message for them to come to the office to receive the results in person.
My Test Came Back Positive. Now What?
Learning that you have an STD or STI is stressful, but it’s important to remain calm and move forward with treatment, as well as get information on how to handle intimate relationships going forward.
What is the treatment for an STD?
The treatment course for an STD depends on which one you have. Chlamydia, gonorrhea, and syphilis can be treated with antibiotics. Herpes and HIV have no cure, but there are medications that can help manage symptoms and prevent you from passing it on to someone else.
How do I tell others I’ve been intimate with?
It’s important to let past partners know as soon as possible. People can work with their doctor to determine who should be contacted based on the amount of time it takes for someone to contract the condition. For example, people who have gonorrhea or chlamydia should contact people they had relations with during the 60 days prior to being tested.
How long should I avoid intercourse?
First and foremost, people should begin treatment for an STD before engaging in any intimacy. After receiving treatment, they should wait at least a week before they resume physical activity with someone.
What if it’s a serious result? Is there anyone I can talk to?
Getting a positive result to an STD test can be difficult to cope with psychologically and emotionally. People in this position can get support from their doctor in order to deal with the effects of treatment, and may be referred to a counselor if necessary.
Staying Safe During Intimacy
Whether you have received a positive result on an STD test or not, you need to handle intimacy in a safe manner. Although refraining from intimate activity is the only way to stay 100% safe, the following precautions can reduce your risk:
1
The fewer partners you have, the less likely you are to contract a virus or disease. Monogamous relationships between two people who have been tested is one of the safest ways to go.
2
Condoms (male or female) don’t mean 100% safety, but they do reduce your chances of contracting an STD. If you’re going to be intimate with someone new, or if you have multiple partners, make sure you use one.
3
Intimacy with a new partner doesn’t need to mean intercourse. Starting slower and progressing after comfortability and testing can reduce your risk, as well.
4
If you’re sexually active, get tested at least once per year, and ideally every six months. And if you think you’ve been exposed to a virus or disease, get tested immediately.
5
While some may connect it to cleanliness, womenhealth.gov links douching to a number of health issues, including bacterial vaginosis, pelvic inflammatory disease, and even HIV.
6
If you’re bringing intimacy toys into the bedroom, make sure you wash them thoroughly after use. Viruses and bacteria can remain on surfaces for hours after completion.
STD & Intimacy Questions Answered by Experts
Everyone has questions when it comes to STDs and STIs. Lots of misconceptions and misinformation exists. Our panel of experts has taken the most common questions and misunderstood aspects of STDs and answered and addressed them below.
Kristy Goodman is the Co-Founder and CEO of PreConception Inc., an online service that provides direct-to-consumer preconception testing for women who are planning a pregnancy. Kristy is a women’s health PA with an M.S. in PA Studies and an MPH in Health Education and Behavioral Science from the University of Medicine and Dentistry of New Jersey. Kristy completed a postgraduate fellowship in Ob/Gyn and has worked in a variety of settings including sexual health, obstetrics, and infertility evaluation and treatment. Kristy lives in Los Angeles, California, and can be found on Instagram @theobgynpa.
Dr. Jordin Wiggins is a Naturopathic Doctor, entrepreneur, women’s sexual health disruptor, and author The Pink Canary (published March 10, 2020). She is revolutionizing the way we deliver, educate and talk about sexual health, wellness, and pleasure for women. In her private practice (which she owns and operates), Health Over All, Dr. Wiggins and her team are experts on hormone and mood imbalance, libido, bio-marker testing and providing individualized health care so that their patients wake up energized and ready to take on their day. She is setting a higher standard for women’s sexual health, using pleasure as the way back to better relationships, desire and outstanding health, not another pill.
Dr. Patrick Fratellone is an integrative MD/clinical herbalist practicing in New York City and Fairfield Connecticut. He has been in private practice for 25 years. He specializes in cardiology, autoimmune disease, Lyme, and cancer. He is a professor at the University of Bridgeport College of Naturopathic Medicine. His books and medical journal articles are well-known. www.ratellonemedical.com
How can people deal with testing positive for an STD? How can they navigate the physical and emotional effects?
Goodman: It’s important to remember that you’re not alone. Statistically, one in two people will have an STI at some point in their lives, so it’s likely that you know many people who have also had an STI and just haven’t told you. Make sure you get answers to all your questions, understand whether the STI is curable or not, and what you can do to help protect yourself and your partners in the future. There are several websites that offer online support groups for people diagnosed with an STI and there are even dating sites specifically for people who have incurable STIs, such as herpes.
Dr. Wiggins: A lot of the physical and emotional effects of contracting an STI come from lack of education and stigma surrounding them. STIs are essentially a cold for your genitals. We aren’t embarrassed when we catch a cold from someone, so why are we so embarrassed when it involves sex? Get tested, get treated, inform your partners when they are at risk and actively work on removing the inherent shame/bias you carry about people who have STIs because it is not helping anyone to be safe or get the right treatment.
Dr. Fratellone: Disclosure of a sexually transmitted infection to current or former partners is most important to the prevention and treatment of the STI. If you test positive, you should tell your intimate partners. You can always ask your healthcare practitioner to tell your partner(s) with you present.
I understand it might be embarrassing or even frightening, but it is imperative to be honest with your partners. The thought of getting tested or possibly a positive result might can some anxiety or depression. At this time, seeing a therapist might be a benefit.
What are the best ways to handle disclosing an STD to a potential partner?
Goodman: STI status should be disclosed before engaging in any physically intimate activity with a potential partner. Be open, honest, and upfront about what STI you have and then discuss things you can each do to help protect your partner from being infected (wearing condoms, taking suppressive therapy for certain STIs, like herpes). STIs are so common you may even discover that they have one, as well.
Dr. Wiggins: Keep it light, get straight to the point, offer sources of education and materials for your partner if they are not as educated in this area as you would like them to be. And remember, this conversation is uncomfortable for everyone, but the more we have it, the easier it will be…and if your partner is responsible and has had partners in the past, hopefully they are already well practiced in the art of STI status disclosure.
Dr. Fratellone: There is never a good time to tell your partner. Depending on which STI you have, you might need to tell them even earlier. You must plan a strategy. If you have an active oral herpes lesion, you should tell them before you kiss. If you have a genital STI, then it’s important to tell your partner before you have any type of intercourse: fingering, oral, vaginal, or anal.
What are some common misconceptions about STDs?
Goodman: One of the most common misconceptions I hear from patients and other healthcare providers is that you cannot test for herpes if someone isn’t having symptoms. This is not true at all. There are specific blood tests that can test for both Type 1 and Type 2 herpes and are quite accurate if done three to six months after the last possible exposure. While interpreting a positive herpes Type 1 test can be difficult in the absence of prior symptoms (most HSV-1 infections are oral but 1/3 of genital herpes is caused by HSV-1), a positive test for herpes Type 2 almost always means that the individual was exposed genitally. Testing positive for someone who has never had symptoms can sometimes be a shock, but it also gives you and your partner the ability to discuss ways to reduce risk to either yourself or your partner (depending on who has the infection).
Dr. Wiggins: That people who have them are gross and dirty, that it can’t happen to you, that birth control protects against STI transmission, that you don’t need to get tested if you used condoms or are only intimate with one person.
Dr. Fratellone: There are many misconceptions or myths about STDs that need to be discussed. You can get an STD from oral stimulation. STIs are very common. More than 95 percent of the population has oral herpes or fever blisters. It is not painful nor embarrassing. What it is an STI/STD. You can afford to get tested if you need. There are many clinics that do free testing. Although treatments may be expensive, there are affordable clinics and free treatments available. You should know that oral contraception does not protect you against an STD.
What are the most important things people should keep in mind about STDs?
Goodman: Not everyone who has an STI will tell you about it before having sex, so it’s important that you take steps to protect your own health. STIs are common, but can have lifelong consequences. Taking steps to decrease your risk of getting an STI, such as wearing condoms consistently and asking your partners to get tested before engaging in sexual activity, is so important and can make the difference between you having an infection or not.
Dr. Wiggins: STIs are not scary or shameful. They are a potential and real consequence of something wonderful and amazing — consensual sex. Communicate, protect yourself, get tested, and get treated.
Dr. Fratellone: Anyone having intercourse without a condom can get an STD. You should always use a condom no matter what. Some of these STDs are life threatening. Exposure to Treponoma pallidum, the spirochete that causes syphilis, has both neurologic and cardiologic consequences that are life threatening and deadly. Treatment for an STI is mandatory. There are conventional medications that can prevent recurrences as in the use of acyclovir or Valtrex for herpes simplex oral and genital infections. Some individuals use the amino acid lysine to prevent recurrence and some use the herb, Melissa officinalis also known as Lemon Balm. If you feel symptoms of burning in urination, a discharge or any pain in the genital region, seek medical attention. Use protective barriers as condoms during intimacy.
Additional Resources for STD Support and Information
6 Strategies for Breaking the Stigma of Living With an STD
This article from US News Health discusses how people with an STD can talk about their condition without fear or shame.
This American Sexual Health Association page explores the emotional toll that being diagnosed with an STD can take.
How You Can Prevent Sexually Transmitted Diseases
The Centers for Disease Control and Prevention offers information on how to avoid getting an STD, or giving it to someone else, on this page.
Just Diagnosed? Next Steps After Testing Positive for Gonorrhea or Chlamydia
This site from the CDC gives guidance on how to handle a positive result on a Gonorrhea or Chlamydia test.
The CDC offers information on how STDs can impact pregnancy, as well as treatment options for pregnant women, on this page.
The videos and podcasts on this page include STD information from the CDC.
Sexually transmitted disease (STD) symptoms
This webpage includes information from the Mayo Clinic on the symptoms associated with different types of STDs.
Sexually Transmitted Diseases Treatment Guidelines
This report from the CDC includes information on how sexually transmitted diseases are treated.
On this page, Planned Parenthood provides information on the different types of STDs, as well as facts about testing and practices that can reduce the risk of contracting one of these conditions.
What You Need to Know About STDs
On this site, Stanford University Health debunks myths about STDs and provides information on how people can protect themselves.