Sexually Transmitted Diseases (STDs)

Sexually transmitted diseases (STDs) are often surrounded by fear, shame, and stigma. In reality, they’re simply infections passed through sexual contact, not plagues inflicted on the morally corrupt. So although the topic might feel uncomfortable to discuss, accurate information about STDs empowers people to protect their physical and mental health, seek appropriate care when needed, and move beyond embarrassment and toward better sexual health and well-being.

Understanding STDs

STDs are infections passed from one person to another through vaginal, anal, penile, oral, or genital skin sexual contact. Bacteria, viruses, or parasites can cause them, and while some STDs are chronic and require long-term management, many STDs are treatable and temporary ^[1].

While the term STD is widely used, an often-preferred term is sexually transmitted infection (STI). It’s typically considered more accurate, as an infection occurs when a pathogen enters the body and begins multiplying. An infection only becomes a disease when symptoms develop, which means people can have an STI and no symptoms, but never develop an STD. Bottom line: Using the term STI emphasizes the fact that not all of these infections result in long-term disease, and use of STI over STD may help reduce stigma.

Regardless of the term used, both STIs and STDs are major global concerns. According to insights from the World Health Organization, within those aged 15 to 49, more than 1 million curable STIs are acquired daily worldwide ^[2]. Within the United States, statistics point to similar prevalence levels. Data from the Centers for Disease Control and Prevention (CDC) reveal that more than 2.4 million cases of syphilis, gonorrhea, and chlamydia were reported in 2023 ^[3]. Despite these somewhat alarming stats, timely testing, treatment, and safe sexual practices can significantly reduce the impact of STIs.

STI Signs and Symptoms 

While the source of infection differs between STI types, and although symptoms vary by the stage of the infection, many STIs share overlapping signs and symptoms. Some are mild and easily overlooked, while others may cause noticeable discomfort. 

Common symptoms of STIs include: ^[1]

• Painful or frequent urination 
• Unusual discharge from the penis or vagina, or vaginal bleeding unassociated with menstruation
• Sores, bumps, or warts on the genital area, mouth, or anus
• Itching, irritation, or swelling in the genital region
• Pain during sexual intercourse
• Fever, rash, night sweats, diarrhea, or flu-like symptoms 
• Weight loss

Common Types of STIs

STIs include a wide range of conditions, each with its own symptoms and treatment options. Some are highly treatable and curable, while others require ongoing care to manage their chronic effects. 

Chlamydia Trachomatis 

Caused by bacteria, chlamydia is easily spread through vaginal, anal, or oral sex. Many people don’t notice initial chlamydia symptoms, but the infection can lead to fever, pain, and abnormal discharge. Without treatment, it may cause pelvic inflammatory disease, infertility, or complications during pregnancy and delivery. Because it responds well to antibiotics, timely treatment is key to preventing reinfection and long-term harm ^[4].

Herpes (HSV-2)

Herpes is caused by the herpes simplex virus (HSV), which has two types: HSV-1, often responsible for cold sores, and HSV-2, which is more commonly associated with genital herpes. Symptoms can include painful blisters around the mouth, genitals, or anus, though many people have few or no noticeable signs. While there is no cure, daily medication can reduce outbreaks and lower the risk of passing the virus to partners ^[4].

Human Immunodeficiency Virus (HIV)

HIV attacks the immune system by destroying the blood cells that fight infection. Untreated HIV can progress to acquired immune deficiency syndrome (AIDS), leaving the body vulnerable to diseases and certain cancers. The virus is primarily transmitted through unprotected sex and shared needles. Early treatment and preventive measures, such as antiretroviral therapy, condoms, and pre-exposure prophylaxis (PrEP) medications, can help prevent infection and transmission ^[4].

Human Papillomavirus

Human papillomavirus (HPV) is the most common STI, with over 40 types that can infect both men and women. While many HPV infections cause no symptoms, some types lead to genital warts or cancers of the cervix, vulva, penis, anus, or mouth. HPV can’t be cured, but vaccines can prevent most cancer-causing types, and medications can manage some symptoms ^[4].

Risk Factors for STIs

Several factors can increase a person’s likelihood of contracting an STI. Among them, having unprotected vaginal, anal, or oral sex remains a primary risk factor, particularly when people have multiple sexual partners or engage in sexual activity with someone whose STI status is unknown ^[5].

Substance misuse also increases STI risk by impairing judgment ^[5]. Additionally, shared needles, such as those used with intravenous drug use or with tattoos or piercings performed with unsterilized needles, can transmit blood-borne infections like HIV and hepatitis ^[1].

Practical Ways to Reduce Risk

Preventing STIs includes a combination of behavioral choices and medical interventions. Abstinence offers the only form of complete protection. However, sexually active people can significantly reduce their risk through strategies ranging from barrier methods and vaccines to regular screenings and preventive medications.

Barrier Prevention Methods

Physical barriers remain essential tools for STI prevention. When used correctly and consistently, dental dams and latex and polyurethane condoms can reduce transmission of several types of STIs ^[5].

Routine Screenings and Vaccinations

In terms of preventatives, vaccines such as those for HPV and hepatitis A and B offer powerful protection. However, regular screening is a key strategy for those who are sexually active. Since many STIs can be asymptomatic initially, regular screenings can help to identify STIs early, which allows for timely treatment and protection of sexual health ^[5].

Biomedical Prevention for HIV

PrEP is a daily medication regimen that can dramatically reduce the risk of HIV infection. Two options are approved by the U.S. Food and Drug Administration (FDA): Truvada and Descovy. When taken as prescribed, Truvada can lower sex-related HIV risk by roughly 99% and injection-related risk by more than 74%. Descovy is also effective for lowering sexual HIV transmission, but limited statistics are available across all populations ^[5].

Regular STI Testing

STI testing forms a cornerstone of sexual healthcare, allowing for early detection and treatment before serious complications develop. Most healthcare providers recommend annual STI testing, with more frequent testing advised for individuals with multiple partners ^[1].

Different infections require different testing methods. For example, blood tests detect antibodies or antigens for infections like HIV, hepatitis, and syphilis, and urine tests can identify bacterial infections such as chlamydia and gonorrhea. In some cases, swabs of the throat or anus offer another non-invasive testing option for bacterial STIs [6]. Additionally, fluid samples from skin sores and discharge, as well as cell samples from the body, can also be used to test for STIs ^[1].

STIs and Mental Health

For some people, an STI diagnosis can bring more than physical challenges. Feelings of shame or guilt are common, and the stigma surrounding STIs can intensify these emotions. This stress can lead to anxiety, depression, or withdrawal from relationships. However, the reverse is also true, as mental health issues can give rise to risky sexual behaviors that result in STIs ^[7].

Risky Behaviors and Mental Health

Mental health disorders can shape sexual decision-making. Specifically, they’ve been linked to risky behaviors such as having multiple and often unfamiliar partners and failing to use preventative measures effectively ^[7].

With some mental disorders, this risky behavior is due to a lack of knowledge about STIs and susceptibility to being coerced into unsafe behavior. However, other disorders may involve limited impulse control and difficulties establishing stable relationships, which then result in high-risk behavior. What’s more, many people turn to substance misuse as a way to cope with mental health conditions, particularly when misused, substances lower inhibitions and limit a person’s ability to make sound, safe-sex decisions ^[7].

HIV and Mental Health

The same yin and yang relationship exists between HIV and mental health disorders. U.S. adults with a serious mental illness (e.g., psychotic disorders, bipolar disorder, recurrent major depression, or co-occurring mood and substance use disorders) have an HIV prevalence of 2% to 6%, which is considerably higher than the 0.5% seen in the general population ^[8].

Conversely, the chronic nature of HIV can create ongoing psychological stress and anxiety ^[9]. In fact, the lifetime prevalence of depressive disorders ranges as high as 22% among those with HIV, compared to up to 10% in the general population ^[10].

While these stats are concerning, evidence-based care can help. Routine mental health screenings within HIV services, access to psychotherapy and medications for mood and anxiety disorders, and integrated substance use treatment can support overall well-being. With coordinated care that addresses both mental and physical health, many find steadier routines, stronger relationships, and more confidence in managing HIV over time.

Physical Healthcare Resources

Treatment for STIs varies depending on the specific pathogen involved. Some infections respond well to antibiotic therapy and antiparasitic treatments. Other conditions may not be curable, but they can be effectively managed with medications that reduce symptoms, prevent complications, and lower the risk of transmission. 

The following sites offer search tools to help locate testing, vaccine, and treatment services:

• CDC GetTested: Search by zip code to locate HIV, STI, and viral hepatitis testing and vaccines. 
• HIV.gov: The U.S. government offers this location-based search tool for HIV testing, services, and PrEP information.
• HRSA.gov: The Health Resources and Services Administration (HRSA) offers a search tool that covers 15,500 health center service sites.
• MentalHealth.com: This site offers state-specific listings for therapists and resources.

Mental Health Resources

Emotional care can move in parallel with medical treatment for STIs. Therapy options such as cognitive behavioral therapy, trauma-focused approaches, and couples counseling are often recommended for anxiety, depression, relationship strain, and decisions about disclosure. Additionally, teletherapy and support groups extend access, while crisis services provide immediate backup when distress escalates. 

Mental-health referral websites and crisis call centers include: 

• 988 Suicide & Crisis Lifeline: Call or text 988 for a free and confidential conversation 24/7. 
• AASECT: The American Association of Sexuality Educators, Counselors, and Therapists offers a geographic therapist search tool.
• FindTreatment.gov: This federal treatment locator connects people with mental health, substance use, and co-occurring disorder care.
• NAMI Helpline: The National Alliance on Mental Illness offers a support helpline via 800-950-NAMI (6264). People can also reach the NAMI Helpline by texting ‘NAMI’ to 62640 or by emailing [email protected]. 

A Healthier Tomorrow

Living with or recovering from an STI involves more than managing physical symptoms. The journey often encompasses emotional healing and personal growth. While challenges exist, so do resources, treatments, and support communities that can help people move forward with confidence and hope.

Sexual health remains an essential component of overall well-being throughout life. With facts in hand and support nearby, people can choose steps that fit their daily life, from screening and safer sex to counseling and community resources. Plus, by addressing both the physical and mental health aspects of STIs, people can break free from cycles of shame and fear. 

Just remember that small actions build momentum. Baby steps taken today can strengthen health, connection, and well-being tomorrow.