Amber Kraft, C.N.P.
Obstetrics & Gynecology (OB-GYN), Prenatal Care
You probably remember having some form of the safe sex talk with your parents or other adults. The focus of the conversation was likely around pregnancy, or at the very minimum, how not to get pregnant. These conversations, including choosing abstinence, are extremely important to have with young adults, and it's equally important to discuss the topic of sexually transmitted infections (STIs).
What is an STI?
"I tested positive for syphilis, and I'm not sure what that means" or "Did you know 1 in 5 people have herpes?" may not be socially acceptable lunch conversation, but it's common conversation at a medical visit. Most patients have some information regarding STIs, but there is confusion and misinformation on the subject. Sexual health concerns are sometimes ignored due to fear of the unknown.
STIs generally are acquired by sexual contact, but some may be passed from mother to infant during pregnancy or childbirth, or through blood transfusions or shared needles. The organisms that cause STIs may pass from person to person in blood, saliva, semen or vaginal fluids. STIs can have a range of symptoms, including no symptoms, so it is possible to contract an STI from someone who seems perfectly healthy or who may not even be aware of the infection.
Although there are many different types of STIs, the most common are chlamydia and genital herpes.
Chlamydia is a common infection, especially in teens and young adults. Often, there are no signs or symptoms of the infection, so it can be passed to partners without intent. Chlamydia is treated easily with antibiotics, but if all sexual partners are not treated, the infection will continue to spread or reinfection can occur. To help ensure all partners receive medication for the infection, partner treatment, called expedited partner therapy, can be prescribed.
The legal scope of expedited partner therapy varies from state to state. For example, in Minnesota, the treating provider can prescribe treatment to the partner(s) without a medical evaluation. There may be an out-of-pocket expense for the medication. After treatment, I recommend rescreening in two to three months, annual screening or with any new exposure. If chlamydia goes untreated, it can cause future fertility problems.
Genital herpes also can also be contracted or passed without awareness of the infection because there may not be any signs or symptoms of the virus. Genital herpes is passed during vaginal, oral or anal sex. It is an infection that cannot be cured. Genital herpes can be painful, and cause blisters and open sores on the genital area. While symptoms can be treated, the virus remains present in the body.
Making informed decisions about your partner and when to choose to be sexually active is an important part of preventing your exposure to STIs. Share your sexual history with your partner and ask them to share with you so you can make wise sexual decisions. I encourage patients to bring their partner to gynecology appointments to have open, honest conversations with your partner and health care provider.
Condoms are still the best barrier protection against STIs. Over time, we have seen condom use may not be as common because of improved birth control methods. Long-acting reversible contraception, such as an IUD or rod implants, are nearly 100% effective in preventing pregnancy but do not protect against STIs. Even though condoms can't prevent the spread of all infections, it is better to be safe than to not use one at all.
I recommend HPV vaccine to all people 9–45 to prevent contracting HPV, a sexually transmitted virus that can cause cancer. The best immune response occurs when the vaccine is given around 11 or 12. For those under 15, the immunization is a two-shot series. For those over 15, a three-shot series is administered over six months.