Here's something to think about: one in two sexually active people will get an STI (sexually transmitted infection) by the age of 25, and half of the 20 million new cases of STIs reported each year occur among 15- to 24-year-olds, according to the American Sexual Health Association. That's why the CDC recommends women under 25 who are sexually active get tested for common forms of STIs like chlamydia and gonorrhea annually. Talking with your doctor and partner about these sexually transmitted infections — otherwise called STDs (sexually transmitted diseases) but more accurately referred to by many health professionals as STIs since most don't become actual diseases — can be, well, awkward. We're here to help with the guidance of two ob-gyns as well as Remi Cruz, one of YouTube's most genuine, well-known vloggers.
What Is STI Testing Like?
Anyone, regardless of who your sexual partner is or what kind of sex you're having, can contract an STI. "STIs are sexually transmitted across all kinds of sex," Jennifer Conti, MD, an ob-gyn at Stanford and cohost of The V Word podcast, told POPSUGAR. Jessica Shepherd, MD, an ob-gyn and gynecologic surgeon at Dallas's Baylor University Medical Centre, said it's important to do STI testing for people in any type of sexual relationship, no matter the sex or gender. "This is true especially if there are sex toys involved, as they can carry infections as well," she noted, adding that women who have sex with women have a greater risk of bacterial vaginosis, which increases the likelihood of transmitting STIs.
Common STIs include chlamydia and gonorrhea (these are the ones that the CDC recommends you get tested for each year if you're under 25 or have new sex partners). Trichomoniasis is another one of the most common STIs; it results in a million new cases in the US yearly. Testing for these is easy, Dr. Conti said, because it's "typically through a urine test or even in combination with your pap smear." Some may require blood tests. Dr. Shepherd said that these STIs may or may not show symptoms, so it's a good idea to proactively get tested if you're sexually active.
For example, chlamydia symptoms can be mild to the point where you don't notice them, or they appear several weeks after you've contracted the infection, according to the CDC. If symptoms do occur, they could include abnormal vaginal discharge and painful urination. Same goes for gonorrhea — most women with gonorrhea don't have symptoms, but if they do, they're similar to chlamydia symptoms with the addition of vaginal bleeding between periods. Herpes is a common STI as well that might not result in noticeable symptoms at first, or the sores that appear might be confused with ingrown hairs or pimples. If the blisters break, then you'll probably experience painful sores accompanied with flu-like symptoms.
All STIs are treatable, but only some are curable, Dr. Conti said. Bacterial infections like chlamydia and gonorrhea respond well to antibiotics, but a viral infection like HIV is not yet curable. It can, though, be treated with a combination of drugs called antiretroviral therapy (ART) that help manage the progression of the virus. Hepatitis C, she explained, is an example of a viral infection that only recently became curable with the medication Harvoni. The CDC recommends HIV testing for people who have unprotected sex or share intravenous needles for drug use once a year at minimum, and you should be getting tested for HIV at least one time if you're between the ages of 13 to 64, the CDC advises.
Getting Tested for STIs "Is Self-Care"
Remi, 24, who has partnered with the American Sexual Health Association's Yes Means Test campaign, opened up on her podcast Pretty Basic and, later, her online platforms, about losing her virginity last year. (You can watch Remi's Yes Means Test campaign video here.) Remi, with a YouTube following of over 3.7 million subscribers — her channels are MissRemiAshten and RemLife — and over a million more on Twitter and Instagram combined, told POPSUGAR that she didn't think about getting tested before she was sexually active. Now, she values it as a form of self-care because she's putting herself first, and it's the safe and smart thing to do.
Remi was scared to get tested but reflected that there's nothing to be afraid of because it's convenient and "completely painless." She said. "I thought it was going to be a giant performance, and it ended up being you walk in and you walk out. It's so easy." Most insurance covers STI testing, Dr. Shepherd said, and if yours doesn't, or if you don't have insurance, many clinics offer confidential testing for free. You can find a clinic near you at yesmeanstest.org.
How to Start the Conversation About STIs
Some gynecologists test for STIs as a routine part of a regular checkup, Dr. Shepherd said, but many wait until their patients ask to be tested, "so be confident in speaking up." Sharing your sexual history and experience with your doctor is the only way they'll know what tests are right for you, she explained, and if you don't feel comfortable, you may want to consider switching doctors.
In terms of asking your partner about STIs, Remi stated the obvious: it might be uncomfortable. From her personal experience, she said it can involve a lot of stress, but "you won't regret it in the end." No matter how the conversation goes with that person, Remi stressed the importance of going to get tested — and so did both ob-gyns — because of the fact that many STIs can be transmitted without realising if symptoms aren't prevalent enough to be detected in the first place.
Having conversations about sex and sexual health is part of a healthy relationship, Dr. Shepherd said. If you get a positive test result, this can be another uncomfortable situation, she told us, but she encourages people to discuss the reality that STIs are common (she referenced the stats we mentioned earlier). She continued, "Sharing the news is a proactive and healthy way to take care of your personal health and the health of your partner. It's better to be up-front and honest."
There's a negative stigma around contracting — even talking about — STIs, Remi said, but she believes that helping spread awareness is her duty. In today's society, losing your virginity in your 20s is considered "late," and opening up about feeling those pressures really resonated with Remi's online audience. Hearing from her followers, many of whom have sent her messages thanking her for providing them with resources to find clinics near them, reminded her of the impact her platform can have. "I'm glad that I can be the voice for someone who may be confused about a lot of this stuff," Remi said. It's what she would have wanted growing up.
Last Important Notes on STIs
Here are a couple additional crucial reminders:
- STIs can be picked up through many different types of sexual activity whether that's vaginal, oral, or anal sex.
- Even genital skin-to-skin contact can spread STIs.
- Not all STI cases show noticeable symptoms.
- Not all contraception protects against STIs. Using male and female condoms can significantly reduce the risk for HIV and STIs spread through bodily fluids like gonorrhea and chlamydia. But the FDA notes that condoms are less effective in preventing STIs spread through skin-to-skin contact like herpes and syphilis. Birth control pills, in comparison, do not prevent STIs.
- Hepatitis B, Hepatitis A, and HPV vaccinations are also available for teens and young adults.
- The CDC states that the most reliable ways to avoid STIs are abstinence and being in "a long-term mutually monogamous relationship with an uninfected partner".