April is STI Awareness Month
This April, in honor of STI Awareness Month, take some time to learn about sexually transmitted infections (STIs). Anyone who is sexually active can get an STI, so why not learn more about them and how to minimize your exposure to STIs and take care of your sexual health.
CDC marks its own STI Awareness Week in April with the theme Talk, Test, Treat. It’s a good framework to think about STIs and your sexual health. Let’s start with talk—there’s a lot to talk about!
and not just about sex (but yes, also about sex).
Talking openly and honestly about sex and sexual health makes for relationships that are more fun and satisfying. STIs are one part of that talk—when you were last tested for STIs, which ones, and what the results were. You can also talk about how often you get tested and whether you’ve had any partners since your last test. Having an open and honest conversation about STIs before you become sexually intimate is ideal.
But there’s so much more to talk about! What safer sex precautions do you want to take? Are you interested in a monogamous relationship or not? What gets you excited? What kind of touch do you like…and what do you not like. On that note, what are your boundaries?
Sounds like a lot, doesn’t it? Where do you even begin? What if you want to talk about a positive STI diagnosis? How do you bring up the topic of pleasure? Evalene Dacker, MD, is a physician and sexual health educator who has created a great model that helps guide the conversation—the STARS Model. STARS is an acronym that stands for : Sexual Health and STI Status, Turn-Ons, Avoids, Relationship Intentions and Expectations, and Safety Needs and Safer Sex Etiquette.
In this interview, Dr. Dacker describes the STARS model and does roles plays showing how real life conversations about these topics would go, including discussions of testing status and talking to a partner about a positive diagnosis for herpes. Like ASHA, Dr. Dacker believes we should destigmatize conversations around sex, sexual health, and STIs. As she says, “The worst STIs that we give each other are shame, guilt, and fear.”
You might think you’d know that you have a sexually transmitted infection, because you’d have some kind of sign or symptom that something was wrong. That’s true sometimes—STIs can cause symptoms like itching or burning or sores or discharge. But many times, probably much more often than you think, there are no symptoms at all. STIs can be “silent.” That’s why the term STI is more frequently used than STD, or sexually transmitted disease. You can be infected with an STI but have no symptoms of disease.
That’s where testing comes in. The only reliable way to know if you have an STI is to get tested.
But what tests do you need? And how often should you be tested? There are some general guidelines—for example, the CDC recommends that all sexually active people assigned female at birth ages 15-24 should be tested for gonorrhea and chlamydia every year. These infections are common among this population, and untreated gonorrhea and chlamydia infections can cause serious health complications like infertility (the inability to conceive or carry a pregnancy).
Ideally, your provider should be starting the conversation about your sexual health and the tests that are recommended for you. This video from the National Sexual Health Coalition outlines what a visit should look like—with a provider-led discussion of the 6 Ps—your partners, sexual practices, past history of STIs, pregnancy prevention, and prevention of STIs. The sixth P stands for plus, and includes questions about pride, sexual problems, and pleasure.
How great would it be if every provider followed this model! But unfortunately, not every provider will start the conversation. It’s good to come prepared with your own questions, to make sure you get the information you need. While you may have more questions to ask about your sexual health and relationship, these are just a few example STI-related questions:
- I want to make sure that I’m taking all of the right steps to protect myself from sexually transmitted infections. Where should I start?
- How can I talk to my partner about STIs? Can you give me some advice?
- I want to make sure that my partner and I get tested before we have sex. How can I bring up the topic?
- Given what we’ve talked about in terms of my relationship history, should I be tested for STDs/STIs? Which ones?
- How often should I be tested for STIs? Which ones?
To be clear, you deserve to have a healthcare provider that you trust. They should be someone who is open-minded, honest, and very good at listening. If you feel uncomfortable with your healthcare provider for any reason, follow your instincts; ask around for other recommendations. Your good health depends on your ability to communicate and rely on your healthcare provider!
Here’s the good news—many STIs are curable and all STIs are treatable. There are some STIs caused —like chlamydia or trichomoniasis—that can be treated and cured with antibiotics. Viral STIs like herpes and HIV can’t be easily cured with medication, but they can be treated. Treatment for these infections can also help reduce the possibility of passing the infection on to a partner.
If there is any bad news it’s this—treatment can cure or treat infections, but it can’t help with any health problems that might develop before the infection is treated. For example, if chlamydia goes undiscovered and untreated in a person with a uterus, it can lead to a condition called pelvic inflammatory disease (PID), a serious infection the uterus, fallopian tubes and ovaries. PID can lead to infertility the inability to become pregnant or maintain a pregnancy), chronic pelvic pain, or ectopic pregnancy. In someone with a penis, untreated chlamydia can lead to prostatitis (inflammation of the prostate gland), scarring of the urethra, or infertility.
The takeaway is clearly that it’s best to discover and treat any infections as early as possible, to avoid any other health issues. This is why regular testing is so important if you’re sexually active.
- Take the STI Quiz
Test your knowledge about STIs with our short online quiz.
- Personal Stories
ASHA has long collected stories from individuals willing to share their experiences with STIs. While we use these in our patient advocacy work, we also share them here as a way to help others and show how common, and manageable, such experiences are.
- Why Talking about STDs Can Be Healing
This podcast from Jenelle Marie Pierce, founder of The STI Project, an independent website and progressive movement dismantling stigma by reclaiming STI narratives through awareness, education, and acceptance with story-telling and the use of comprehensive, inclusive, accurate, relevant, empathetic, and pleasure-focused resources.
- YES Means TEST
This ASHA campaign focuses on a simple message—if you’re saying yes to sex, you should say yes to testing. Getting tested for STIs can be simple, is often free, and is an essential step toward taking care of your sexual health.