Living with an STI

Getting a sexually transmitted infection (STI) can be a new and scary experience. Luckily, there are many resources available to treat all STIs, as well as to cure the STIs that are curable. We recommend that people seek treatment as early as possible following any concern that they may have been exposed to or contracted an STI. Many STIs present as asymptomatic so it is not possible to know whether or not one has an STI definitively without consulting a clinician. 

STIs are prevalent in the United States, impacting the lives of 19.7 million individuals on an annual basis.1 Luckily, a majority of these STIs will not cause long-term harm. Only a minority lead to serious health problems if not properly diagnosed and treated early. Young people between the ages of 15 and 24 are the most likely to be affected by an STI.2 Overall, more than 110 million men and women nationwide have either a new or existing infection.1

What Are STIs and How Are They Transmitted?

Sexually transmitted infections (STIs)are infections that are spread through sexual contact including but not limited to penetrative penis/vagina sex, anal sex, and oral sex. 

STIs can also be spread through sharing drug needles, breastfeeding (if the mother is infected with an STI) or other methods which expose one to the bodily fluids of an infected person.3 A full list of STIs and more information on particular STIs can be found here

Initial Reactions to an STI Diagnosis

It is natural to feel upset when one is informed that they have an STI. Sadness, anger, fear, and worry are all common emotions that one experiences when receiving their diagnosis. Every emotion and reaction that you have is valid. Know that you are not alone and that leaning on close friends, community members, or professional mental health resources are all reasonable and healthy ways to process the news. Over 1 million STIs are acquired daily worldwide and while most of these will not have any symptoms, many can have serious health consequences if left untreated. It is important to seek medical attention promptly if one has an encounter they feel may have put them at risk of contracting an STI.4

Important Considerations Related to STIs

The vast majority of STIs are completely treatable. There are various actions an individual can take to prevent another STI in the future and to undergo the proper medical treatments to alleviate the symptoms of a current infection.1 In addition to being treatable, STIs are preventable. Therefore, despite their prevalence, it is entirely possible to prevent both transmitting and contracting STIs with proper education and implementation of safe and healthy sex practices. Communicating honestly and effectively with partners, using barrier methods such as condoms or dental dams, and getting appropriately vaccinated are all actions that can effectively prevent one from contracting or transmitting STIs.5

Contracting an STI in the past does not necessarily prevent you from contracting that same STI or others in the future, so it is important to maintain these safe sex practices whether one has had an STI before or not.6 Additionally, it is possible to get multiple STIs concurrently, so even if one has an STI, such as herpes, which is not curable (though it is suppressible and treatable), they are just as likely as anyone else to contract another STI. 

There are numerous factors that influence the likelihood of contracting and transmitting STIs such as safe sex practices, getting tested regularly and type of sexual act.6  It is also important to note that if one is participating in higher risk sex acts, then there may be additional health considerations or steps for ensuring safe sex. For example, with anal sex, using lubrication and going slowly can reduce the prevalence of anal tissue tears. These precautions make it harder for STIs to transfer from partner to partner. Overall, the spread of STIs and the experience of living with an STI are both varied and not easily captured by any one fact or statistic. It is important to be open-minded and nonjudgmental when thinking about and engaging in dialogue related to living with STIs. 

Navigating Stigma Related to STIs Following a Diagnosis

If one finds themselves diagnosed with an STI, they may find comfort in the fact that they are not alone – STIs are extremely common. Being diagnosed with an STI does not detract from one’s worth as an individual, make one a “bad” or “dirty” person, or define one as an individual. Additionally, contracting an STI (curable or not) does not inhibit one’s ability to lead a fulfilling life, nor does it prohibit one from continuing to engage in love, relationships, or sexual intercourse. In fact, many people with an STI still have sex on a regular basis and maintain healthy, loving relationships.7

Despite these facts, stigmas related to sexuality and STIs in particular remain prominent in many places around the world. Many of the stigmas surrounding STIs stem from their association with sex, which is still commonly regarded as a taboo subject. However, STIs can also be transmitted by sharing needles with someone carrying an STI.6 Related stigmas also stem from a lack of understanding about what exactly STIs are, how prevalent they are, and how easily many of them can be cured with proper resources and medical attention. 

Honesty and education are important to decreasing stigmas, as well as normalizing discussions about STIs with friends, partners, and other members of the community. When discussing topics such as STIs, it is important to be well-educated on relevant facts because misinformation is common and can be harmful when it concerns people’s health and well-being. While one cannot control the stigma a particular community harbors or spreads with regard to STIs or other sexual health topics, it is possible to be aware of that stigma and to prevent oneself from internalizing those negative messages. 

Curable vs Un-Curable (But Still Treatable!) STIs

All STIs have treatment available in some form, however, not all STIs are curable. In this article, we differentiate between curable and non-curable STIs for the purpose of exploring the different ways these STIs impact the lives of people who have them.

Curable STIsChlamydiagonorrheasyphilistrichomoniasisnongonococcal urethritis (NGU)Pelvic Inflammatory Disease (PID)vaginitisscabiespubic lice

These STIs are curable with proper medical attention and treatment. All of these STIs may cause temporary discomfort, but when treated promptly and effectively, it is likely that there will be no long-lasting damages. However, leaving curable STIs untreated can lead to serious and unnecessary health concerns over time. 

Certain STIs (e.g., scabies and pubic lice) require critical steps in a treatment regime, such as washing sheets and clothes, in order to avoid reinfection.Refer to the symptoms and treatment article to learn more about specific symptoms of each STI, as well as specific treatment options. Note that many STIs are asymptomatic and therefore do not have symptoms, so a lack of symptoms does not necessarily mean that one does not have that STI.5 If one feels that they could have been exposed to an STI, they should see a medical provider as soon as possible in order to get tested (and treated if necessary). It is also important to avoid having unprotected sex while receiving treatment in order to avoid transmission. 

One particular treatment to be aware of is expedited partner therapy (EPT).EPT is an available treatment for chlamydia and gonorrhea where the doctor prescribes medication for the partner of their patient at the same time without personally evaluating their patient’s partner. This practice prevents further transmission while additionally preventing the partners from re-infecting one another.9

STIs That Are Not Curable (But Are Treatable): HerpesHIV/AIDSHuman Papillomavirus (Warts and Cervical Cancer), Hepatitis B

Incurable STIs may require more attention and continued treatment than other STIs, but with proper attention to the particular medical recommendations, individuals can still experience a safe and healthy sex life.10 In this section, we will further delve into particular considerations related to each STI.

HIV/AIDS (Not Curable): 

While HIV/AIDS is still not curable, there are many things that people who are either infected or who are exposed to a partner who has HIV can to do minimize their risk of contracting/transmitting the infection. If left untreated, HIV develops into autoimmune deficiency disorder (AIDS) which is life threatening.5

HIV and dating:

Although individuals with HIV must take additional precautions when it comes to sex in order to prevent transmitting the infection to their partners, HIV does not have to prevent people from dating. Serodisconcordant means couples where one partner is HIV positive and the other is negative.11 Seroconcordant couples are both HIV positive or both negative.12

It is possible to suppress viral load to the point that it is undetectable and therefore highly unlikely that it can be transmitted to a partner.13 Clear communication and honesty are important in all relationships – when it comes to discussions and awareness of the risks of HIV/AIDS in a relationship, it is similarly imperative that each partner is as fully informed as possible with their decision processes. 

HIV and the Law:

Many states in the U.S. have partner-notification laws which means that if you knowingly withhold your HIV status from a sexual or needle-sharing partner, you can be charged with a crime.14 Some states have additional requirements that individuals who test positive for HIV are required to either notify partners themselves or by means of a third party. These mandates are part of an effort to reduce the spread of HIV and to ensure transparency between partners when it comes to HIV status.  

Individuals infected with HIV are protected against discrimination under federal law in the U.S.14 Additionally, physicians are bound by HIPPA – a confidentiality agreement with patients. The only exception to HIPPA is that data related to HIV and other STIs is reported to the state public health department in order for the department to most effectively provide services to those who need them. However, when this information is provided, all identifying markers such as name and address are removed. 

Herpes (Not Curable): 

Herpes is an STI that, once contracted, is lifelong. Herpes is not deadly, is very treatable2 and typically presents no serious health problems.15 However, it is highly infectious, so when one is experiencing an outbreak, they should refrain from exchanging bodily fluids through sexual activities to prevent spreading herpes to their partner(s). The first outbreak of herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) (or herpes) is typically the most severe, with outbreaks getting further apart and less severe as time goes on.15

Herpes can be either oral or genital, but it is possible to transfer either type to the other location.15 This is important to keep in mind when considering whether or not to engage in sexual activity. When one is not experiencing a breakout, it is not necessary to alter sexual behavior and it is up to the individual’s discretion if and how they want to convey their status to any potential partners.

Treatment:

Treatment recommendations for herpes vary; most likely a medicine will be prescribed as well as other methods of expediting the sores recovery per your doctor’s recommendation such as: placing an ice pack on sores, keeping genital area dry, taking pain reliever such as ibuprofen etc.6

Herpes and Pregnancy:

If one is experiencing an active outbreak, one should not proceed with a vaginal birth due to the risk of transferring the herpes to the child. Otherwise, no changes need to be made. Additionally, mothers (and anyone interacting with young children) infected with herpes need to be particularly careful when they are experiencing an outbreak not to kiss or touch their child with any part of their body that has come in contact with their sores in order to prevent transmitting their herpes to their child.  

HPV (Not Curable):

Human papillomavirus (HPV) is the most common STI, and while there is no treatment for the virus itself, there are a multitude of treatments available for the diseases that it can potentially cause.

There are also a variety of vaccines to prevent certain types of HPV infections.2 HPV has the potential to lead to either genital warts or certain types of cancer, though most often it presents as asymptomatic.16 Many people are unaware they have HPV despite the fact that most sexually active people will contract it at some point in their lives if they do not get the HPV vaccine.16 Vaccinating against the cancerous strains is the most effective preventative strategy an individual can employ, in addition to practicing safe sex methods such as barrier protection, and effective partner communication. 

Hepatitis B (not curable): 

While most cases of hepatitis B respond to a vaccine that doctors can deploy post exposure, chronic hepatitis B can also develop, and this form of hepatitis B has no cure. Vaccination is the most effective way to prevent against Hepatitis B.17 Additionally, it is important to use protection when coming in contact with sexual fluids and blood.18

STIs and Partners

Communicating STI diagnosis with partners

Communicating the status of one’s STI to current and previous partner(s) is vital in order for them to seek appropriate medical care and resources. Though relaying one’s STI status to one’s partner(s) is likely not a conversation most people look forward to, there are several steps one can take to maximize the effectiveness of the conversation. We recommend having conversations regarding STI status, protection, and safe sex practices prior to any sexual contact. However, all of these recommendations apply regardless of when one has this conversation. 

While one cannot control how one’s partner reacts, it is possible to be intentional with when and how one conveys this information. The following recommendations are applicable regardless of the STI:15

  • “Keep Calm”– you are not alone in experiencing this STI and many people before and after you will be struggling with the same things you are. Feel free to practice what you want to say ahead of time or write it down to ensure you are as comfortable as possible with what you wish to convey in the conversation. 
  • “Make it a Two-Way Conversation”– if talking about your own STI feels too intimidating as a conversation starter, start by discussing safer sex practices and STI testing in general with your partner. It is possible that they or someone they know has had an STI before.
  • “Know Your Facts”– misinformation quickly complicates matters that otherwise can be fairly straightforward. Go into the conversation with your partner well-versed in the particular STI you are experiencing so that both you and your partner will be able to make the most educated decisions possible.
  • “Think About Timing”– this is a conversation you do not want to spring on your partner. Be intentional about when you bring it up to them and make sure it is a time when both of you are ready to sit down and talk, are in the right headspace to have a productive conversation, and are in private and will not be interrupted.
  • “Safety First”– your safety comes first. If you are at all concerned for your personal safety with regard to talking to your partner in person about your STI, we recommend contacting them via email, phone, or text instead, or in serious cases – not at all. See resources at the bottom of this page if you are experiencing interpersonal violence within your relationship. 

Overall, although conversations about STIs are not the most comfortable conversations to be having in the bedroom, they ultimately save a lot of time, energy, and money. For your well-being, as well as that of your partner(s), take the time to have these conversations so that everyone can maximize their pleasure and sexual well-being. 

Concluding Remarks

When it comes to sexual health, STIs are a part of life. It is to one’s benefit, as well as the general health and safety of one’s community, to keep well-informed and well-versed in all matters related to STIs. Safe sex practices, destigmatizing conversations surrounding sexual health and STIs in particular, and effective medical care can all go a long way when it comes to the experiences of people living with an STI. Always remember that one’s experience with an STI is not a defining part of who one is – it is merely one aspect of sexual health that’s impact can be mitigated through open conversation and responsible health practices. 

Resources:

References

  1.  “Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United States.” Centers for Disease Control and Prevention. N.p., n.d. Web. 2008. 
  2. “STD Testing | Facts on STD Testing Procedures.” STD Testing | Facts on STD Testing Procedures. N.p., n.d. Web. 28 Jan. 2015.
  3.  “Sexually Transmitted Diseases (STDs).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 Oct. 2019.
  4.  “Sexually Transmitted Infections (STIs).” World Health Organization, World Health Organization, 14 June 2019.
  5. Parenthood, Planned. “Safer Sex (‘Safe Sex’): Reduce Your Risk of Getting STDs.” Planned Parenthood.
  6.  “You and Your Family.” Washington State Department of Health.
  7.  “Relationships.” American Sexual Health Association: Your Source For Sexual Health Information.
  8. Parenthood, Planned. “Where Can I Get Treated For Scabies?: Treatment Info.” Planned Parenthood.
  9.  “Expedited Partner Therapy.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 26 Aug. 2019.
  10. “SECTION V: Sexually Transmitted Infections.” Technical Issues In Reproductive Health”, Columbia University. N.p., n.d. Web.
  11.  “HIV Prevention for Serodiscordant Couples.” AIDSFree.
  12.  “Concordant Couple Definition.” National Institutes of Health, U.S. Department of Health and Human Services.
  13.  “Preventing Sexual Transmission of HIV.” HIV.gov, 12 Mar. 2019.
  14.  “Civil Rights.” HIV.gov, 19 Mar. 2018.
  15. Parenthood, Planned. “Living with Herpes: Common Questions and Answers.” Planned Parenthood.
  16.  “STD Facts – Human Papillomavirus (HPV).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 20 Aug. 2019.
  17.  “Hepatitis B Questions and Answers for the Public.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 13 Jan. 2020.
  18. Koenig, Aaron, et al. “Vaccination against Hepatitis A and B in Patients with Chronic Liver Disease and Type 2 Diabetes: Has Anything Changed?” Onlinelibrary.wiley. John Wiley & Sons, Inc, 2 June 2016. Web.

Last updated: 20 February 2020.