Amber Kraft, C.N.P.
Obstetrics & Gynecology (OB-GYN), Women's Health
You probably remember having some form of the safe sex talk with your parents or having it with your own children, but more than likely the focus of the conversation was around pregnancy, or at the very minimum, how not to get pregnant. Although these conversations are extremely important to have with young adults, it’s equally important to touch on the topic of sexually transmitted diseases (STDs), sometimes called sexually transmitted infections (STIs).
WHAT IS AN STD?
“I tested positive for chlamydia, and I’m not sure what that means?” or “Did you know 1 in 5 people have herpes?” may not be a socially acceptable lunch conversation, but is part of a common conversation at a medical visit. Most patients have some information regarding STDs, but there still is confusion and misinformation on the subject. Therefore, sexual health concerns are sometimes ignored due to the fear of the unknown.
STDs 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 STDs may pass from person to person in blood, semen or vaginal and other bodily fluids. STDs can have a range of symptoms, including no symptoms, so it is possible to contract an STD from someone who seems perfectly healthy or who may not even be aware of the infection.
Although there are many different kinds of STDs, 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 a bacterium that is treated easily with one dose of antibiotics, but if all sexual partners are not treated, the infection will continue to spread or reinfection can occur. To help ensure all partners are treated, 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 is able to prescribe treatment to the partner(s) without a medical evaluation. There may be an out-of-pocket expense if the partner does not allow the provider to access their medical record. After treatment, I recommend annual screening or screening with any new sex partner or 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, and is an infection that cannot be cured. Genital herpes can be painful, and cause blisters and open sores on the genital area.
Condoms are still the best protection against STDs, but over time, we have seen that they may not be used as often because of other improved birth control methods. Long-acting reversible contraception, such as an IUD or rod implants, are nearly 100 percent effective in preventing pregnancy but do not protect against STDs. Even though condoms can’t prevent the spread of all infections, it is better to be safe than to not use one at all. It’s important to share your sexual history with your partner(s). I also encourage my patients to bring their partner with them to their gynecology appointments. It is a great time to have an open, honest conversation, and be able to ask your provider any of those daunting questions.