What to know about preventing sexually transmitted infections

The number of some sexually transmitted infections (STIs) in the United States hit an all-time high during the COVID-19 pandemic. In 2021 alone, more than 2.5 million cases of chlamydia, gonorrhea, and syphilis were reported to the Centers for Disease Control and Prevention (CDC). While cases overall have declined since then, no fewer than 2 million are still reported each year.

“STIs have always been a major problem and concern,” says Alynn Alexander, MD, an OBGYN in Richmond, Virginia. Other infections—such as herpes and human papillomavirus (HPV)—are not routinely reported to the CDC but remain widespread.

Certain people are disproportionately affected. Social, economic, and cultural factors can influence access to prevention and care. This leaves racial and ethnic minority groups, men who have sex with men, teenagers, pregnant people, and transgender people at higher risk.

Many STIs don’t show early symptoms, but can lead to issues like pain, itching, burning, and discharge. When they go undiagnosed and are left untreated, STIs can cause other health issues, such as increased HIV risk and infertility. Some STIs also can result in a higher risk of pregnancy complications, including ectopic pregnancy, miscarriage, premature birth, and stillbirth. The risk of congenital syphilis (when a pregnant person passes syphilis to their fetus) is higher, as well.

STI education is key

Education is the number one way to lower the nationwide STI infection rate, says Alexander. At-risk populations, such as young people and people who engage in risky behaviors—such as having unprotected sex—need to “understand the realities,” she says, because misconceptions abound.

For example, the HPV vaccine is a simple, effective way to protect against a virus responsible for more than 39,000 cancers of the cervix, anus, vulva, vagina, penis, and the mouth and throat each year. But it can’t protect against STIs. “The HPV vaccine does wonderful things for cervical cancer prevention, but it’s not broad coverage for all STIs,” Alexander explains.

Oral sex, too, is not as safe as some people may think. “Some patients feel they’re not sexually active, but they’re active with oral sex and they end up with genital herpes,” Alexander says. “I think the important thing is to continue having open dialogue and enforcing things we know to be true: that STIs are very prevalent and easily transmissible.”

To learn more about STIs and how they’re transmitted, speak with a trusted doctor, nurse, or other healthcare professional. Reliable organizations like the American College of Obstetricians and Gynecologists, Planned Parenthood, and the American Sexual Health Association also offer clear, comprehensive information.

Tried-and-true STI prevention methods

Beyond learning about STI risks, you can take precautions to stay healthy. Abstinence remains the best way to avoid getting or giving an STI, but safe practices can also offer protection. These include:

• Using condoms and other barrier methods like dental dams consistently and correctly
• Avoiding risky sexual behaviors
• Not misusing substances like drugs or alcohol
• Choosing monogamy or limiting your number of sex partners
• Keeping an open dialogue with partners about sexual behaviors
• Getting vaccinated for HPV

Screening for STIs is also a key part of prevention. Make sure to speak with a healthcare provider about what kind of tests you might need. Unless you’re completely abstinent, it’s important to get tested regularly.

The CDC’s recommendations for STI testing are:

• All people between the ages of 13 and 64 should be tested for HIV at least once.
• Women ages 24 and younger who are sexually active should be tested annually for gonorrhea and chlamydia. Women ages 25 and older should continue to test yearly if they have risk factors, like new or multiple sex partners.
• Pregnant people should get tested for a variety of STIs beginning in the early months of pregnancy, including hepatitis B and C, HIV, and syphilis.
• Men who have sex with men should test at least once each year for syphilis, chlamydia, gonorrhea, and HIV. If they have multiple or unknown partners, they should test every three to six months.
• People with HIV should test for hepatitis C at least one time per year.
• People who inject drugs and share equipment should test for HIV at least annually.

If you have had oral or anal sex, reach out to a healthcare provider to discuss your testing options. They may recommend tests for the throat or rectum (last part of the large intestine before the anus).