How do I know if I have an STI? (QOTM Nov 2021)

How do you know if you have an STI? That’s a difficult question to answer, because there are many STIs with different symptoms for each. The best way to know for sure is to be tested by your doctor, but they even have home tests you can take these days.

The Centers for Disease Control and Prevention (CDC) estimate that there are about 20 million cases of sexually transmitted diseases or infections per year. Roughly half of those occur in people of the age of 15 to 24.

The most common symptoms of many STIs include burning or painful sensation while urinating, itching and sores or rash on the genitals. Depending on the STI (or what stage of the infection), some people however may not experience any symptoms at all. It is still possible to pass an STI to a partner without even knowing that you have one. That is why it is so important to get tested, if/when you think you may have been exposed.

Most STIs are treatable and curable. But if left untreated there is a risk of long-term complications, illness infertility or even death.

What activities can put me at risk for both STIs and HIV?

The following activities can increase your risk of getting STIs

• Anal, vaginal, or oral sex without a condom or barrier
• Sex with multiple partners
• Having anonymous sex partners;
• Having sex while under the influence of drugs or alcohol can lower inhibitions and result in greater sexual risk-taking.
• Exposure to blood from injuries or sharing needles

Condoms and barriers are a great way to reduce the transmission of STIs, if used correctly. But please remember that even barrier methods are not 100% effective.

Each STI by itself would be worthy of a blog post by itself (and we may revisit that at a later stage), but without further ado, here are the most common STIs:

Human Papilloma Virus (HPV)

One of the most common types of STI in the US. There are over 40 types of HPV, some of which cause genital warts. Since many strains of the virus do not cause visible symptoms and clear without treatment it is common for people to not know they have it and pass it on.

Caused By

Human Papilloma Virus

Symptoms

Many types of HPV never cause any symptoms. Others cause genital warts. Small pink or flesh-colored bumps in the genital area that may cause itching, discomfort and bleeding. Some types can be detected during a routine screening PAP smear. Some types may cause cervical cancer. Other types may cause cancer of the genitals, mouth, anus and throat. There are usually no initial signs or symptoms with HPV infections.

Treatment

Most types of HPV disappear without treatment permanently (even though they may stay inside the body for a few years before they finally clear). There is a vaccine to prevent certain types of the virus. The warts themselves can be treated with various medications (some available over the counter)

Herpes

Herpes is highly contagious. It is estimated that 50 to 80 percent of U.S. adults have oral herpes. According to the National Institutes of Health, about 90 percent of adults will have been exposed to the virus by age 50. Once infected, a person will have herpes simplex virus for the rest of his or her life.

Caused By

Herpes simplex type 1 (HSV-1) or herpes simplex type 2 (HSV-2)

Symptoms

The most common symptom of Herpes is are cold sores or fever blisters (oral herpes). It can also cause also genital or anal sores. Both types of herpes (type 1 and 2) can be sexually transmitted and cause genital herpes. Herpes can also potentially affect a developing fetus in a pregnant person, especially if there is an infection during the first trimester.

Treatment

There is no cure for Herpes. The outbreaks can be managed with antiviral medications, that are available as ointments or pills. There have been various vaccines in trials, but so far none have been successful.

Syphilis

Syphilis is an STI that can serious health problems if is left untreated. A syphilis infection is separated in stages primary, secondary, latent and tertiary. Symptoms change with the stages. For some people syphilis may not show symptoms at all and so you may not be able to see it in your partner.

Caused By

Syphilis is caused by the bacterium Treponema Pallidum. It spreads through direct contact with sores.

Symptoms

Primary Syphilis begins with a painless round and firm single sore where the bacteria first entered into the host body (on/in the genitals, mouth or anus). Secondary Syphilis is characterized by skin rash, swollen lymph nodes, and fever. Both primary and secondary syphilis symptoms may be mild and may even go unnoticed. Latent stage syphilis shows no symptoms at all. Tertiary syphilis is associated with severe medical problems and can become extremely damaging to various organs such as skin, heart, blood vessels, brain, nervous system, liver, bones and joints. The damage to these organs can lead to death

Treatment

Syphilis can be treated with the correct antibiotics administered by a health care provider. These antibiotics may not cure all the damage caused (in later stages). Having had syphilis doesn’t mean you are immune to it and you may get it again.

Hepatitis

Hepatitis is an inflammation of the liver caused by different viruses. There are Hepatitis A, B and C and some of them can be sexually transmitted. Left untreated or if becoming acute, they can become damaging to the liver and ultimately cause liver failure.

Hepatitis A (HAV) is found in the feces of people and is spread by close personal contact (including living with an affected person), drinking untreated water contaminated by HAV, Hepatitis B (HBV) is found in the blood of affected people and can be transmitted sexually or by being exposed to blood (from injury or sharing needles), Hepatitis C (HCV)is also found in Blood and sexual fluids. HCV infection is considered to be the most common chronic bloodborne infection in the United States, with an estimated 2.4 million persons living with chronic infection. HCV is a reportable condition in most states.

Caused By

Hepatitis virus A, B or C

Symptoms

All forms of Hepatitis can cause tiredness, nausea, vomiting, stomach pain, dark urine, and yellowing of the skin and eyes, They can also be asymptomatic in early stages. There is a chronic form of HBV and HCV, which can lead to serious liver damage, such as scarring of the liver, cancer, liver failure, and even death.

Treatment

There are vaccines for Hepatitis A and B, and these are the most effective prevention. There is also hepatitis B immune globulin (HBIG) available to prevent infection. There is no vaccine for Hepatitis C. Most patients with acute HAV infection require only supportive care, with no restrictions in diet or activity. If the patient becomes too dehydrated or are showing signs of liver failure, hospitalization may become necessary. There is no specific therapy for people with acute HBV infection. Treatment is only supportive. HCV is curable with antiviral agents, depending on the type and severity and stage of the disease. All need to be administered by a health care provider.

Trichomoniasis

Trichomoniasis (sometimes called “trich”). It is considered the most common curable STIs in the U.S. The CDC estimates that there were more than two million trichomoniasis infections in 2018. The parasite passes from an infected person to an uninfected person during sex (vagina to penis, penis to vagina and vagina to vagina). This infection usually only affects the genitals, not the anus or mouth. So in women this can be found usually in the lower genital tract (vulva, vagina, or urethra), and in men, inside the penis (urethra).

Trichomoniasis can cause genital inflammation. This can then make it easier to get infected by other STIs such as HIV or make it easier to pass other viruses onto a partner. The infection can last months or years without treatment.

Caused By

This STI is caused by a protozoan parasite called Trichomonas vaginalis

Symptoms

Only about 30% of the affected develop any symptoms of trichomoniasis and it is unclear why some people do not develop symptoms. Even without symptoms it is possible to spread the disease. Infection is more common in women than in men. Older women are typically more likely than younger women to have been infected with trichomoniasis. For people with vaginas, symptoms can include: itching, burning, redness or soreness of the genitals, discomfort with urination, or a thin discharge that can be clear, white, yellowish, or greenish, with an unusual smell. For people with penises, symptoms can include itching or irritation inside the penis, burning after urination or ejaculation, or some discharge from the penis. Having trichomoniasis can make it feel unpleasant to have sex.

Treatment

Trichomoniasis can be treated with the correct medication (antibiotic) prescribed by a doctor. These pills are taken by mouth. It is safe for pregnant women to take this medication. Having had and having successfully been treated for Trichomoniasis does not make you immune. About 1 in 5 people get infected again within 3 months after receiving treatment. TO avoid reinfection, all sex partners should receive treatment with antibiotics at the same time.

Gonorrhea     

Gonorrhea is a STI that affects people of all genders. It most often affects urethra, cervix, rectum or throat. It can be spread through vaginal and anal sex. It can be transmitted from mother to unborn child. In babies it mostly affects the eyes.

There are very severe long-time complications with this disease. If left untreated in people with wombs it can spread to the rest of the reproductive organs. The gonorrhea spreads to the uterus and fallopian tubes, causing pelvic inflammatory disease (PID). PID can cause scarring of the fallopian tubes, create greater risks of complications during pregnancy and ultimately infertility. In people with penises and testicles, gomorrhea can cause the Epididymis to become inflamed (a condition called Epididymitis). This part of the reproductive system connects the testicles to the vas deferens, which in turn connects to the urethra. Untreated epididymitis can lead to infertility. Gonorrhea can lead to stiffness of joints and bacterial arthritis and increase the risk of HIV/Aids. It makes you more susceptible to infections with HIV and make it easier to pass both diseases to your partners. Lastly, the disease can lead to comlications in babies. Babies who contract gonorrhea from their mothers during birth can develop blindness, sores on the scalp and infections.

Caused By

Gonorrhea is caused by a bacterium called Neisseria gonorrhea. It grows in warm, moist areas, such as urethra, eyes, throat, vagina, anus, and the female reproductive tract.

Symptoms

In many people there are no symptoms. For those who develop symptoms, most common are pus-like discharge from the penis, swelling of one testicle, increased vaginal discharge, vaginal bleeding between periods (such as after vaginal sex), abdominal or pelvic pain in people with vaginas, and a burning painful sensation during urination. Gonorrhea can also affect other parts of the body. In the rectum it can cause itching, pus-like discharge, bright red blood on toilet tissue and having to strain during bowel movement. If gonorrhea affects the eyes it can cause pain, light sensitivity and pus like discharge. In the case of a throat infection it can cause sore throat and swollen lymph nodes. Lastly it can affect joints and casue septic arthritis. The affected joints can show swelling, become warm and red and be very painful, especially when moving.

Treatment

Traditionally Gonorrhea has been treated with antibiotics. In recent years Gonorrhea has developed resistance to the antibiotic drugs. Even with different, newer antibiotics this trend has continued.

Chlamydia

Chlamydia is the most commonly reported bacterial STI in the United States. It is easily cured, but untreated, chlamydia may lead to PID and cause ectopic pregnancies and infertility. If you are pregnant and have chlamydia, you can pass the infection to your baby during delivery. This can potentially cause an eye infection or even pneumonia in your newborn. Chlamydia may also cause you to deliver your baby too early.

Caused by

Chlamydia is a bacterial disease caused by Chlamydia trachomatis

Symptoms

Most people affected by Chlamydia develop no signs or symptoms. Others may experience burning sensation while urinating or vaginal or penile discharge. Rectal chlamydia infection can lead to discharge from the anus, rectal pain, mucous with stools, painful bowel movements and redness in the anal area. Chlamydia in the throat can lead to sore throat, dental problems, mouth pain, mouth sores that don't heal and sores around lips and mouth.

Treatment

Once a test confirms that you have chlamydia, there are various medications and treatment regimes available to treat chlamydia. If you’ve had chlamydia and were treated in the past, you can still get infected again.

Human Immunodeficiency Virus (HIV)

The human immunodeficiency virus (HIV) is an infection that causes acquired immune deficiency syndrome - AIDS. Left untreated, HIV is a life-threatening infection. It weakens the body's immune system. HIV can be passed from an infected person to an uninfected person through contact with blood and sexual fluids. The virus can also be passed from an HIV-infected mother to her child.

If you get an STI, you are more likely to get HIV than someone who is STI-free. The reason for that is that the same behaviors and circumstances that may put you at risk for getting an STI can also put you at greater risk for getting HIV. In addition, having a sore or break in the skin from an STI may allow HIV to more easily enter your body.

Caused By

Human immunodeficiency virus

Symptoms

Early stage HIV infection may include flu-like symptoms such as swollen glands, fever, muscle aches, headache, extreme tiredness. These typically last for a short time about 2-4 weeks. After that the disease enters into a stage called “clinical latency” whre there is an absence of symptoms (or very mild symptoms). This time can last for years especially with treatments (see below). Late stage HIC is called AIDS. The virus has weakened the immune system. Symptoms such as unexplained and significant weight loss, profuse night sweats, fever, frequent and severe rare infections, persistent dry cough, unusual skin rashes, can occur.

Treatment

There is no effective cure for HIV. HIV can be controlled, though. There are treatment options that slow the rate at which the virus multiplies in the body and keep the infection in the latency stage. The most effective is antiretroviral therapy (ART). This is a combination of several medicines.

Summary

While the most common symptoms include burning or painful sensation while urinating, itching and sores or rash on the genitals, some people may not experience any symptoms at all. It is still possible to pass an STI to a partner without even knowing that you have one.

If you, or a loved one, have any signs or symptoms of an STI, or if you or a loved one were exposed to an STI speak with a healthcare provider right away.

If you are sexually active, especially with multiple or changing partners or people at risk, get tested for STIs and HIV regularly, even if you don’t have symptoms.

DISCLAIMER: 
* This article is not meant to replace medical advice or treatment by a professional health care provider. Please visit a health care provider if you experience any symptoms or think that you have been exposed and get tested.
* For further and much more thorough/complete information, please visit CDC STDs page