Chances are, you’ve heard some sketchy information on the subject of sexually transmitted infections, or STIs. Rumors and myths about STIs are common. We don’t all have access to reliable sex education, and even accurate information can become outdated. But maybe, most of all, talking about STIs can feel weird. So, here. Read about them instead. Here are the answers to your most common questions about STIs.
1. What’s the difference between STIs and STDs?
STIs (sexually transmitted infections) and STDs (sexually transmitted diseases) are essentially different terms for the same thing: the bacteria, viruses, parasites, and other organisms that can infect people through oral, vaginal, and anal sex. STIs can be spread through bodily fluids such as semen, vaginal fluid, and blood, and via skin-to-skin contact.
Technically, “disease” implies that symptoms are present—which is often not the case with STIs. “Disease” may also feel more stigmatizing. Most sexual health educators working in colleges and universities say “STIs.”
2. Which STI gets around the most? And how can I fend it off?
Human papillomavirus (HPV) is one of the most common STIs. In Canada, it’s estimated that 75 percent of sexually active men and women will have at least one HPV infection in their life, but most people with healthy immune systems will eventually clear the infection from their bodies. Most of the people who are infected are in their late teens and early 20s.
Nearly all sexually active men and women become infected with HPV at some point in their lives. Many strains of HPV don’t usually cause harm, but some strains of HPV can cause genital warts and cancers of the cervix, anus, penis, vulva, mouth, and throat.
- There are three vaccines that protect against some strains of HPV—you can get them up to the age of 27, and they may be administered to women and men older than 27 who are at ongoing risk of exposure to HPV. You can also be vaccinated for hepatitis A and hepatitis B. Schedule a visit with your health care provider to get vaccinated.
- Use a condom and/or dental dam every time. These don’t guarantee protection but do reduce your risk.
- If you’re sexually active, get tested once a year or with every new sexual partner. Discuss the availability and accuracy of tests with your health care provider.
- Get comfortable talking about sex and STI prevention. This means:
- Feeling empowered to talk about what you want or don’t want sexually
- Discussing pleasure and what feels good to both of you
- Becoming comfortable with getting tested and asking partners to get tested as well
- Discussing the use of condoms (external and internal), lubrication, and dental dams (oral dams) to reduce exposure to STIs
- If unintended pregnancy is possible, discussing methods of birth control
3. Am I more likely to get accidentally pregnant or get an STI?
You’re twice as likely to get an STI as you are to get accidentally pregnant.
About one percent of college and university students in the US said they or their partner experienced an unintended pregnancy in the last 12 months, according to the most recent data available from the National College Health Association survey. Just over two percent said they’d experienced an STI. Since 1997, there has been a steady increase in rates of STIs in Canada, the US, and the UK.
4. What’s the difference between HPV and herpes?
Human papillomavirus (HPV) is often confused with herpes (herpes simplex virus, or HSV). These are two different viruses. They’re both transmitted through skin-to-skin contact.
HPV can cause genital warts and cancers of the cervix, anus, penis, vulva, mouth, and throat. Many strains of HPV don’t usually cause harm, however. There are three vaccines that protect against some strains of HPV—you can get them up to age 27, and they may be administered to women and men 27 years of age and older who are at ongoing risk of exposure to HPV. Talk to your doctor.
Herpes can cause sores at the point of infection, which may be in the genital area or on the mouth. Many people who’ve been infected with herpes experience no symptoms or have mild symptoms that they attribute to other conditions. Treatment can help minimize the symptoms and lower the chance of transmission.
5. Which STIs should I get tested for?
Getting tested for STIs is a gateway to treatment and helps you protect yourself and your partner(s). Most tests are noninvasive and simple. Get tested for these conditions once a year or whenever you have a new sexual partner. Discuss with your doctor about whether to get tested for other STIs as well.
Medication can help minimize outbreaks but cannot cure herpes.
What’s the test like?
Testing usually involves a health care provider taking a swab of the affected area and/or a blood test.
These can be present without symptoms and can cause fertility problems in men and women if left untreated. Both are curable with antibiotics.
What are the tests like?
Usually a doctor will ask for a urine sample or take a swab of the genital area.
In 2014, it was estimated that 75,500 Canadians were living with HIV, yet 20 percent were unaware.
What’s the test like?
A swab can be taken from the inside of the mouth, or a health care provider will take a blood sample.
Can cause severe complications such as brain damage or blindness if left untreated (usually after many years). It can be cured with antibiotics, but antibiotics can’t reverse any permanent damage caused by the disease. New cases are most common in men who have sex with men.
What’s the test like?
It usually involves a blood test or a sample taken from a sore.
Where can I get tested for STIs?
See your doctor or your school’s health and wellness centre.
6. How likely am I to get an STI?
In Canada, women and men between the ages of 15 and 29 are most affected when it comes to certain STIs.
Are STIs your fate?
No. To minimize your risk of becoming infected:
- Use a condom or dental dam every time.
- Get tested with every new sexual partner or once a year if you have the same partner.
- Get comfortable talking about sex and STI prevention.
Why are young adults at greater risk of STIs?
- Behaviour (e.g., not using safer sex methods, having multiple sexual partners, and not getting tested). You can control behavioural risks.
- Culture (e.g., discomfort talking about sex and STI prevention, pressure to have sex, and expectations associated with gender roles). Being aware of these influences can help you address them.
- Biology. The physical development of young adults can make you more susceptible to STI infection. For example, in young women, the surface of the cervix is more exposed to some sexually transmitted organisms (e.g., HPV) than in older women.
7. What does an infection look like?
Often, an STI infection doesn’t look like anything. Most STIs don’t have visible symptoms. People who look perfectly healthy can be infected with STIs.
If you’ve ever looked at pictures of STI symptoms, be warned: In real life, symptoms often don’t look like those images. And most symptoms aren’t visible anyway.
Want to know if you or your partner has an infection? STI testing is the only way.
8. How can I talk to my partner about STIs?
What gives STIs their big advantage? Awkwardness. Talking about your sexual health allows you more protection, control, and autonomy. If you have an STI, it’s important to tell a partner before engaging in any sexual activity.
- Have the discussion in advance. Don’t wait until you’re caught up in the moment.
- Make the first move—a conversational move. Don’t wait for them to initiate the STI talk.
- Explain that this isn’t about trust and it’s not about cheating.
- If you’re anxious, acknowledge it: “OK, so this is awkward, but I’m pretty sure we can handle awkward. It’s important to me that we go get tested together.”
- If a partner tells you they have an STI, respect their honesty and maturity and their consideration for you and your needs. Protect their confidentiality.
- If you discuss this sensitively and yet your partner doesn’t want to get tested, be cautious. Healthy relationships require mutual respect and responsibility.
9. Does size matter? And other questions about condoms
Are students using condoms frequently?
A 2013 survey found less than half of Canadian university students report condom use.
Can any other method help prevent both STIs and pregnancy?
No—only condoms (external and internal versions). Latex and latex-free (e.g., polyurethane) condoms are available. For oral sex involving a penis, you can use a dry, lubricated, or flavoured condom. Putting lubrication inside the condom increases sensitivity for both partners and makes the condom easier to put on.
Does condom size matter?
Yes. The condom may stretch, but is it comfortable and pleasurable? Too tight, and the elastic base could cut off blood flow or cause discomfort. Too loose, and it could come off during sex. Condoms are available in varying shapes and sizes, so explore the best fit.
10. What’s a dental dam?
Dental dams (oral dams) probably lower your risk of STIs (but not pregnancy). A dental dam is a thin cover placed over the vulva or anus for oral sex. You can cut a condom or medical glove into a dental dam, or substitute plastic wrap. The effectiveness of dental dams (including plastic wrap) in preventing STI transmission hasn’t been adequately studied; nevertheless, the use of dental dams is recommended by many sexual health professionals.
How can I get some?
Dental dams are available on many campuses for a low cost or for free. They’re also available in some specialty stores or online for about $1.50 each.
11. Which is more common: having a cat or having herpes?
It depends which type of herpes we’re talking about. In Canada, over 1 in 3 households has a cat, according to the Canadian Animal Health Institute, 2017.
More people have a cat than have herpes type 2
In Canada, 1 out of 7 people aged 14–59 has herpes simplex virus 2, or genital herpes, according to results from the 2009 and 2011 Canadian Health Measures Survey. That translates to 2.9 million people, with the incidence being higher among younger people and post-secondary students.
More people have herpes type 1 than have a cat
Herpes type 1 (HSV1) causes cold sores and genital sores. The prevalence of herpes type 1 (HSV1) in Canada is unknown. However, in the US, 54 out of 100 people aged 14–49 have HSV1 (CDC). Among teens, the rate is 3 in 10. Although we think of HSV1 as causing cold sores, this strain of the virus can be transmitted through oral sex and cause sores on the genitals too.
Herpes is very common
To reduce your risk of acquiring or passing on a herpes infection, use a condom or dental dam every time you’re sexually active.
Christine Sturgeon, Community Educator in Sexual and Reproductive Health at the Sheldon M. Chumir Health Centre, Alberta.
Pierre-Paul Tellier, MD, Director of Student Health Services, McGill University, Montreal, Quebec.
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