This month is Sexually Transmitted Diseases (STD) Awareness Month and if there’s one thing we’ve learned in this past year it’s that infection prevention is key to optimal health!
Social distancing, frequent hand washing and mask wearing somehow feel more routine, more regular – a “new normal”, if you will. We find ourselves asking how best to decrease our risk of exposure to COVID so we may keep ourselves and others safe and healthy. At Bloom Ob/Gyn, we ask similar questions about sexually transmitted infections (STIs): How prevalent are STIs in our area? How does risk for STIs affect us individually and as a community? How do we know who is at higher risk and who should be screened or tested?
According to the CDC, STI rates in the United States are on the rise for the fifth year in a row. These types of infections are more common than some of us may realize and often occur without obvious signs or symptoms. While some STIs are relatively harmless and easy to treat, others can have profound implications on an individual’s health status and quality of life.
Who is at risk for getting a STI? Who should be screened and when?
In short, anyone would benefit from STI screening as part of a routine annual health check.
Certain behaviors can put you at higher risk for STIs, including:
- Having sex with multiple partners
- Being sexually active with a partner who has other sexual partners
- Having sex with someone who has a STI
- A personal history of STIs
- Using intravenous (IV) drugs (or being sexually active with someone who does
According to the CDC, sexually active individuals under age 25 in the United States experience higher rates of chlamydia, gonorrhea, and syphilis infections. This is particularly true for individuals living in the District of Columbia, which has the highest rates of reported cases for nearly all STIs in the country. We recommend annual STI screening for all sexually active adults under age 25, regardless of the individual’s perceived sense of risk. Those who are older than 25 might also benefit from routine screening if they have any of the risk factors noted above.
What does STI screening mean? Is this the same as testing?
Screening is a process of identifying individual risk factors and determining one’s own STI status, sometimes through lab work completed during an office visit. At Bloom Ob/Gyn, we offer STI screening as part of your annual Well Woman visit.
Most of it is talking, sometimes labs are involved. In its most basic form, it means talking with your provider about your sexual health. In some cases, we collect blood work to screen for HIV, hepatitis and syphilis. We also collect vaginal or urine cultures to test for gonorrhea and chlamydia.
It’s also important to discuss your relationship safety. Domestic violence and sexual manipulation by a partner can affect an individual’s ability to advocate for condom use. Anxiety and depression can also affect one’s ability to decrease STI risks in relationships and sexual encounters.
Why don’t we screen for herpes?
This is a question that sometimes comes up in discussions with patients about STI screening. Herpes simplex virus (HSV), the virus that causes oral or genital herpes, is fairly common and spreads easily from person to person. The CDC strongly advises against routine screening for HSV through bloodwork because the prevalence in the population is very high:
Nearly 80% of women and men will have antibodies for HSV1 or HSV2 through bloodwork, but never experience clinical symptoms or an outbreak
Blood tests used to screen for HSV do little to tell us when or how a person was infected or if they will ever develop outbreaks. This knowledge rarely has a significant impact on management of herpes, but can have a profoundly negative emotional effect on the person being screened. If you have a painful sore on your mouth or genitals, please schedule a visit at the office to test the actual sore for herpes and we can create a treatment plan based on the culture result.
Testing and treatment
Many common STIs like chlamydia and gonorrhea do not have obvious signs or symptoms. In some cases, if left untreated, these infections can make their way into major reproductive organs, resulting in pelvic inflammatory disease (PID). PID can cause pelvic scarring and infertility. Undiagnosed syphilis can have lasting neurologic and immunologic effects. Failure to complete treatment for these infections can also lead to drug-resistant strains, putting everyone at greater risk. Timely testing and treatment is imperative and, thankfully, most STIs are curable. If you are diagnosed with a STI and complete treatment, be sure to follow up for repeat testing to make sure the treatment worked or that you have not been reinfected.
Getting screened for STIs is important and easy to do. If you have a concern or feel it is time to be screened yourself, please call Bloom Ob/Gyn to schedule a visit. Let’s talk about your concerns and determine a plan for screening that meets your health needs.
Centers for Disease Control and Prevention. (2018). Sexually Transmitted Diseases Surveillance 2018. CDC.gov. https://www.cdc.gov/std/stats18/default.htm
Hess, K., et al. (2012). Intimate partner violence and sexually transmitted infections among young adult women. Sexually Transmitted Diseases, 39(5). doi:10.1097/OLQ.0b013e3182478fa5.
The American College of Obstetricians and Gynecologists. (August 2020). How to Prevent Sexually Transmitted Infections (STIs), ACOG.org. https://www.acog.org/womens-health/faqs/how-to-prevent-stis