10 Myths (and Truths) About Sexually Transmitted Infections
The prevalence of sexually transmitted infections (STIs or STDs) in the United States is increasing, despite public education prevention efforts.
The Centers for Disease Control and Prevention (CDC) estimated in 2018 that one in five Americans has an STI. Two of the 20 cities with the highest infection rates in the U.S. (not including HIV) are in South Florida (Miami ranks 17th highest in the nation, followed by Fort Lauderdale at number 19).
The number of infected individuals in any given city changes yearly as sexual behaviors and societal attitudes about sex shift.
Why do some populations have higher infection rates?
Public access to STI testing and treatment, risk-reduction strategies, infection preventive therapies, STI education, drug needle exchange programs and mental health and housing services varies based on local resources — and likely impacts STI rates.
How can you protect yourself and others from sexually transmitted infections? Understand the truth about your risk.
MYTH: If you use a condom every time you have sex, you have nothing to worry about.
Consistent and proper external (penile) condom use is very effective in preventing the spread of HIV, gonorrhea, chlamydia, and trichomoniasis. But, there are other infections that can be contracted even with proper condom use. These include HPV, herpes, syphilis and chancroid, monkeypox, crabs and scabies and molluscum contagiosum, which spread through contact with mucosal surfaces/secretions or affected skin, which can be outside of the surface area of a condom.
That’s one reason why HPV is the most common STI in the U.S., followed by herpes.
MYTH: Once you get an STI, your sex life is over.
Many STIs are curable, and their transmission to others is preventable with proper vaccination and medical care. Following a professional diagnosis, syphilis, gonorrhea, chlamydia and trichomoniasis can be cured with antibiotics, and hepatitis C can be cured with antivirals. Other STIs (like hepatitis B, HIV, herpes and HPV) have no cure, but treatments are available to reduce the symptoms and the frequency of outbreaks and to help prevent the spread to partners.
With preventive (prophylaxis) antiviral medications, people with herpes can greatly reduce the risk of spreading the virus to others. If you’ve been diagnosed with HIV, you can greatly reduce your chances of giving the virus to your sexual partners by taking antiretroviral (ART) medications, and your partner can be protected by using a pre-exposure prophylaxis medication (PrEP).
By getting vaccinated, your partner can protect themselves against hepatitis B and HPV.
MYTH: You cannot get an STI from kissing.
Although kissing is low-risk compared to penile-vaginal intercourse, anal sex, and oral sex, it is still possible to spread oral (HSV-1) and genital (HSV-2) herpes, HPV, monkeypox and syphilis through deep-mouth kissing alone. That’s because these infections are spread through infected skin-to-skin contact and/or saliva.
MYTH: Oral sex is safe sex.
Because some STIs spread through contact with mucosal surfaces/secretions, affected skin, and/or saliva, both males and females can contract an STI by giving or receiving oral sex.
In addition, genital herpes can spread to the mouth, and oral herpes can spread to the genitals through oral sex. HPV can spread from the genitals to the mouth, which increases the risk of developing genital or oral warts and cancers of the back of the throat, the base of the tongue and the tonsils.
Using male and/or female condoms as a physical barrier during oral sex can reduce this exposure and lower the risk of transmission.
MYTH: You can catch an STI from a toilet seat.
You can undoubtedly find bacteria on toilet seats. But, bacterial and viral STIs cannot survive for more than a brief moment outside the body. So, the chances of catching an STI from direct contact with surfaces like a toilet seat (as opposed to direct contact with infected skin) are extremely low.
MYTH: You cannot get an STI from a used towel or clothing.
STIs that are caused by viruses and bacteria alone cannot be spread through fabrics. This includes syphilis, gonorrhea, chlamydia, trichomoniasis, hepatitis B, HIV, herpes and HPV.
But, crabs (pubic lice) and scabies (caused by burrowing mites) can get trapped in the porous fabric of towels, clothing or bedding and spread from one person to another. These bugs do not survive on hard, non-porous surfaces.
MYTH: You should never have sex with someone who has an STI.
If your partner tests positive for syphilis, gonorrhea, chlamydia or trichomoniasis, they can effectively treat the condition with medication, then resume sexual contact once the infection has cleared. If your partner has herpes (HSV1 or HSV2), they can take a daily antiviral medication to reduce the frequency of their outbreaks and lower the risk of spreading the virus to you, even when the virus goes dormant (shows no symptoms).
Avoid sexual or intimate contact with a partner when they are experiencing an outbreak of genital warts or herpes lesions on the genitals or mouth. During outbreaks, STIs are more contagious. If your partner has HIV, they can take an antiretroviral (ART) medication to make the virus undetectable in their blood, making the infection untransmittable (unable to be transmitted). In addition, you can take a pre-exposure prophylaxis medication (PrEP) to reduce the risk of infection significantly.
You and your partner can use condoms properly and consistently to reduce your risk of contracting HIV, gonorrhea, chlamydia and trichomoniasis. Everyone eligible should get vaccinated against HPV.
MYTH: If you don’t develop signs of infection within two weeks after sex, you didn’t catch an STI.
Some infections take months or even years to show signs. Other infections take only a few days. And many people with an STI never experience any symptoms, or the signs are so mild the infection goes undiagnosed (like syphilis, which can become latent).
Getting tested and retested after a period of months is the only way to get accurate results. Every time you get tested, ensure you know exactly which viruses and bacterial infections you are being screened for. Don’t assume that your health care provider who submits the lab request nor the clinic where your blood is drawn will automatically test you for every possible STI.
Currently, no blood or urine tests are available to detect HPV in males. Testing females for HPV requires a pap smear (via vaginal examination).
MYTH: If you are in a sexually monogamous relationship, you can’t get an STI.
Because many infected people don’t know that they carry a sexually transmissible disease, they are unaware of the risk to their partners. It’s important to discuss with your partner both of your sexual histories and the last time you were tested for STIs.
MYTH: Virgins cannot have an STI.
Even if you never engage in penetrative sex, there is still some risk of contracting an STI. For example, HPV can be transmitted through skin-to-skin contact (including deep-mouth kissing, genital-genital rubbing, oral sex and other skin-genital contacts).
It is also possible to spread oral (HSV-1) and genital (HSV-2) herpes and syphilis through deep-mouth kissing. HIV, herpes, syphilis, gonorrhea, chlamydia, and hepatitis B and C can be passed from mother to baby during pregnancy and birth.
Some STIs can be contracted by ingesting the breastmilk of an infected person.
Written by Dana Kantrowitz, a contributor for UHealth’s news service. Medically reviewed by Maria Luisa Alcaide, M.D., and Laura Beauchamps, M.D., infectious disease experts with the University of Miami Health System.