What Are Sexually Transmitted Infections (STIs)?

Introduction

You have likely heard about sexually transmitted infections or STIs, but what exactly are they? 

While AIDs and HIV are something that easily come to one's mind when talking about Sexually Transmitted Infections (STIs) mainly as a result of mass awareness campaigns in the 90s, there are a dozen other STIs out there in the world that need our focus.   

If you are curious about STDs/STIs and want to take preventive measures, this blog is for you.

What are Sexually Transmitted Infections (STIs)?

Sexually Transmitted Infections (STIs), as the name says, are infections that are transmitted from one person to another through sexual contact i.e. through our sexual organs such as the vagina, penis, anus, and even the mouth. 

Though many of the STIs are incurable, the good news is that there are ways to treat and control them. But hey, as the saying goes, "Prevention is better than cure".

Difference between STDs and STIs

There are different types of sexually transmitted diseases or sexually transmitted infections with their signs and symptoms. 

Let’s make a quick distinction between Sexually Transmitted Diseases (STDs) and Sexually Transmitted Infections (STIs) before we proceed.

While a healthcare provider may consider it important to have a clear distinction between the two; others use them interchangeably. 

This is mainly because making the distinction will help provide the right treatment and thus make treatment more effective.

For example, if left untreated, HIV will lead to AIDS. Here, HIV is an STI while AIDS is an STD. Symptoms of the disease may or may not appear during the infection phase i.e. for STIs symptoms don't need to appear when the person has contracted the virus. 

However, symptoms will become visible at a later stage i.e. when the STI has progressed to STD. In short, STIs are the initial phases of STDs.

Let's get down to the nitty-gritty of these health issues concerning us.

Types of STIs

Sexually Transmitted Infections (STIs) can be grouped into four categories based on their occurrence and curability: 

• Common
• Rare
• Curable
• Incurable

Common STIs: Causes, Symptoms, Diagnosis, and Treatments

As the name suggests, these are the most common infections transmitted sexually, of which the risk of contracting them is high.

They are caused by several factors such as bacteria, viruses, and parasites. 

Examples of Common STIs are: 

HPV (Human Papillomavirus)

Human Papillomavirus is a common STI that causes skin or mucous membrane growths, commonly known as warts.

There are multiple kinds of HPV including the variants that can cause cancer. Skin-to-skin contacts run the risk of spreading it besides sexual contact.

Symptoms

• Bumps that appear pink in colour
• Warts may develop on the skin, including genital areas, hands, and fingers
• Itchiness, discomfort, and occasional bleeding may occur
• High-risk HPV strains can lead to diseases like cervical cancer if left undetected or untreated.

Diagnosis: A routine PAP Smear test. A routine check-up helps in detecting it for early interventions.

Treatment: Vaccination is one effective way to deal with high-risk HPV. 

Hepatitis

Hepatitis is a common disease that targets our liver and can lead to severe liver damage or failure. Viral infections often cause it but can also result from other factors. Transmission can occur through contaminated food or water, blood transfusions, or sexual contact.

Symptoms

There are three types of Hepatitis i.e. Hepatitis A, Hepatitis B, and Hepatitis C. While Hepatitis B is of common occurrence, Hepatitis C is quite rare. 

Their symptoms, however, are more or less the same and they include:

• Dark urine
• Yellow eyes and skin (jaundice)
• Extreme fatigue, 
• Nausea 
• Vomiting

Diagnosis: The infection is diagnosed through a series of tests conducted including a liver function test, liver biopsy, ultrasound, and other blood tests.

Treatment: While a vaccine is available for the first two, vaccines for Hepatitis C are yet to be developed. Also once contracted there is no cure for the disease. However, treatments are available according to the hepatitis one has. The earlier the diagnosis, the more the effectiveness of the treatments. 

Herpes

It is a common contagious STI that is known to cause painful swellings.

It is a sexually transmitted infection which is spread through vaginal, anal, or oral and anal sex with an infected person.

There are two types of Herpes –1) herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

Both types of herpes are transmitted sexually causing genital herpes. Unsafe sex with multiple partners increases the risk of contracting this type of sexually transmitted infection.

Herpes is also known to affect fetuses during pregnancy and cannot be solely categorized as a sexually transmitted infection.

Symptoms

Even though it is not life-threatening, a few symptoms one can look out for in this sexually transmitted infection are:

• The unusual sore 
• Genital discharge that is often smelly
• Burning sensation while passing urine 
• Flu-like symptoms

Diagnosis: A herpes blood test can determine if one has herpes or not as its symptoms can be mild and mistaken for other kinds of skin infections.

Treatment: Herpes is treatable though no cure is available. The infection can only be treated with the use of antiviral medication with a prescription from a healthcare provider.

Human Immunodeficiency Virus (HIV)

​HIV is a common STI transmitted from one person to another through sexual contact and also through other ways such as sharing syringes with an infected person.

However, do not be mistaken, it does not transmit from other body fluids such as saliva or sweat. Even oral sex carries a shallow risk of contracting the virus.

Symptoms

There are no specific symptoms for HIV but any illness in general that one catches due to weak immunity could be its symptoms i.e. even a common cold or a fever could have symptoms.

Diagnosis: According to the Centers for Disease Control and Prevention, there are three ways to diagnose HIV. They are antibody tests, antigen/antibody tests, and nucleic acid tests (NAT).

Treatment

While there are no known cures or medicines developed to cure the infection, there are ways to keep it under control and most people living with the virus can live a normal healthy life if they get treatment before the infection leads to AIDs.

Acquired Immunodeficiency Syndrome (AIDs) is a condition where one's immune system is severely compromised.

HIV, when left untreated can result in AIDs which is why early intervention is necessary.

Syphilis, Chlamydia, Gonorrhea, and Trichomoniasis

STIs, namely Syphilis, Chlamydia, and Gonorrhea are caused by bacteria that are spread through oral and anal sex besides sexual intercourse.

They are a common sexually transmitted infection with more or less similar symptoms and treatments.

They are the bacterial infections that most often cause pelvic inflammatory disease when left untreated.

Trichomoniasis, however, though similar, is caused by a parasite called Trichomonas vaginalis.

Symptoms

If you have Syphilis you may experience:

• Sores on your genitals including your mouth. 
• If left untreated, it can be fatal as it could even cause permanent damage to the heart, brain, genitals, liver, etc.

In the case of  Chlamydia, Gonorrhea, and Trichomoniasis, symptoms include:

• Pain during sex or urination, 
• Discharges which could be yellowish in colour and smelly, 
• Bleeding, etc. 
• And just like Chlamydia, gonorrhea, if left untreated, can lead to infertility. 

Chlamydia is one STI that can be passed from the mother to a baby with the disease in the form of pneumonia or eye infections.

Diagnosis

For Syphilis diagnosis you need to do a blood test.

For Chlamydia, Gonorrhea, and Trichomoniasis, a simple urine test or swab taken from the vagina/penis can detect them.

Treatment

Of STIs given, Chlamydia, Gonorrhea, and Trichomoniasis are curable with the use of antibiotics, under medical prescription by a health provider while Syphilis can be cured at its early stage with penicillin.

Rare STIs, their Signs, Symptoms, and Treatments

These STIs are sexually transmitted but are less common and not as well-known as other STIs.

Although the list is not exhaustive, here we will focus on one rare STI that can be fatal without timely and proper intervention.

The Human T-cell Lymphotropic Virus (HTLV) is one of the rarest STIs that can be of utmost concern as it can lead to cancer.

The HTLV virus can be identified under the same category of virus that causes HIV/AIDS. 

Though rare, this particular STI can be concerning given the severity of the disease and there is no vaccine to prevent it nor an effective cure or treatment. It usually has no symptoms. 

This STI can also result in T-cell leukaemia/lymphoma, rheumatic syndromes, uveitis, etc. Another rare yet deadly STI is Hepatitis C. There is no vaccine available for it yet. 

The risk of getting acute and severe liver damage is high if not treated promptly.

However, the good news is it can be treated effectively.

Curable STIs: These include STIs like syphilis, gonorrhoea, chlamydia, and trichomoniasis. 

Incurable STIs: These are STIs that cannot be cured. They include hepatitis B, herpes simplex virus (HSV), HIV, and human papillomavirus (HPV).

Adolescents and STIs

Sexually transmitted infections (STIs) present a significant challenge among sexually active adolescents, impacting approximately one-quarter of this demographic. 

This prevalence is often intertwined with the psychological dynamics of peer influence and addictive behaviours. 

Adolescents, navigating the complexities of social acceptance and identity formation, may succumb to peer pressure, engaging in risky sexual behaviours. 

Concurrently, addictive tendencies, such as substance abuse, can further heighten these risks by impairing judgment and impulse control. 

Thus, effective interventions necessitate a nuanced comprehension of adolescent psychology, addressing social dynamics and addictive tendencies to promote informed decision-making and mitigate STI transmission risk.

Stigmas and Embarrassment Associated with STIs

Unlike other kinds of infections, STIs and people having such infections are often stigmatised.

Such stigmatisation and embarrassment associated with STIs are significant public health concerns that can have a wide-ranging impact on individuals and communities.

They include:

Stigmatizing Language: The choice of our words matters. For instance, saying “tested negative” or “tested positive” in place of “clean” or “dirty,” or saying “sufferer” in place of “victim” can hugely make a difference in helping someone live with dignity. This approach promotes awareness and encourages responsible behaviour.

Stigma and Judgement: There is a significant social stigma attached to STIs, often leading to judgmental attitudes. This stigma can cause others to distance themselves and show discriminatory behaviour towards STI-positive individuals.

Misinformation and Lack of Knowledge: Many people lack accurate information about STIs, including how they are transmitted and treated. This ignorance can lead to unnecessary fear and avoidance. For instance, some may mistakenly believe that casual contact, like hugging or sharing utensils, can transmit STIs, prompting them to keep their distance.

Fear of Discrimination: Those with STIs may fear being discriminated against by partners, friends, family, or employers. This can deter them from discussing their condition openly or seeking necessary treatment.

Privacy Concerns: The intimate nature of STIs makes individuals more sensitive about their condition. Concerns about privacy and confidentiality in healthcare settings can exacerbate feelings of embarrassment and anxiety.

Psychological Effects

Sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) can have psychological effects on individuals, often stemming from stigma, fear, and anxiety surrounding their condition.

Here are some psychological disorders and issues associated with STIs and STDs:

Anxiety Disorders: Being diagnosed with an STI or STD can lead to heightened anxiety, especially regarding the implications for one's health, relationships, and future sexual activity.

Depression: Feelings of sadness, hopelessness, and shame can arise following an STI or STD diagnosis, particularly if there is a perceived stigma attached to the infection.

Post-Traumatic Stress Disorder (PTSD): Individuals who have experienced trauma related to their STI diagnosis, such as sexual assault or intimate partner violence, may develop symptoms of PTSD.

Sexual Dysfunction: STIs like herpes or genital warts can cause physical symptoms that impact sexual function, leading to feelings of inadequacy, embarrassment, or loss of libido.

Relationship Issues: The disclosure of an STI or STD to a partner can strain relationships and lead to trust issues, communication problems, and even breakups.

Body Image Concerns: Visible symptoms of certain STIs, such as genital warts or herpes sores, may cause individuals to feel self-conscious about their appearance and body image.

Substance Abuse: Some individuals may turn to alcohol or drugs as a way to cope with the emotional distress caused by an STI diagnosis.

Suicidal Ideation: In severe cases, the emotional burden of living with an STI or STD, combined with social stigma and isolation, can contribute to thoughts of self-harm or suicide.

By addressing these factors, society can move toward a more inclusive and supportive approach to sexual health, helping individuals with positive STIs feel less isolated and more accepted.

Preventive Measures

While we might suggest complete abstinence from sex as one preventive measure, questioning the practicality of it is as important.

They can still be contracted from other sources even though one is not involved in any sexual activity.

Here are some preventive measures one can take:

• Using protections such as condoms 
• Getting vaccinated
• Educating ourselves about sexual health
• As a part of the school syllabus, sex education must be given to students as this is the phase of life when one becomes sexually active
• Avoid having multiple partners as it can increase the risk of STIs

Also, doing away with stigmatisation and embarrassment is one of the single most important preventive measures and it can be achieved through:

Education and Awareness: Comprehensive sex education that includes information about STIs, their prevalence, transmission, and treatment can help normalise conversations about sexual health.

Encouraging Open Dialogue: Promoting open and non-judgmental discussions about sexual health in society can help reduce stigma. This includes conversations between sexual partners, within families, and in educational settings.

Confidential Healthcare Services: Ensuring that STI testing and treatment services are confidential and respectful can encourage more people to seek help without fear of exposure or judgement.

Positive Media Representation: Media can play a role in reducing stigma by providing accurate information about STIs and portraying those affected in a compassionate and non-judgmental manner.

Support Networks: Providing support groups and resources for individuals with STIs can help them feel less isolated and more empowered to manage their health.

Hence, it's essential for individuals diagnosed with STIs or STDs to seek support from healthcare professionals, mental healthcare providers, support groups, and trusted loved ones to address both the physical and psychological aspects of their condition.

When to See a Doctor?

There is no reason to overthink and be constantly worrying if you have contracted an STI.

However, if you experience symptoms such as below, it may be a good time to visit a doctor.

• Pain or burning sensation while peeing
• Bleeding on the genitals
• Itching, discharge, or soreness at the genitals, including genital areas and anal region
• Smelly vagina

Sometimes STIs do not show any symptoms which is why routine check-ups for healthy living are a good practice.

Conclusion

Oftentimes, due to misinformation stemming from taboos and stigma around sex, people end up contracting STIs.

People might hesitate to share openly, even with a healthcare provider, fearing judgment. 

By being more vocal about sex and openly discussing it, we can solve almost half of the cases of STI-related problems.

It's this stigma and fear that are often the culprits. Stigma kills more than the disease does.

Remember, consulting an expert can provide accurate information and guidance on managing and preventing STIs.

FAQs

Can STIs pass from mother to child?

Not all but some STIs like HIV, and Hepatitis B can be transmitted from the mother to a child. However, thanks to advancements in the world of medical sciences, many of these diseases can be treated and prevented from affecting newborns.

Can a person with STI live a normal life?

If diagnosed early, even people living with HIV can live a normal life with the right kind of treatment provided.

What are the stigmas around STIs?

The belief that anyone who has an STI/STD is involved in immoral activities, is the root cause behind all this stigma. Only sex education can dispel this belief.

Can I have a relationship with a person living with STD/STI?

The short answer is "Yes, you can." It depends on the partners involved. The most important thing one must keep in mind is consent with your partner. They can figure out a way together based on their consent and suitability.

Can you get STIs even when you do not have any sexual relationship with anyone?

Yes, you can contract STIs even without being sexually intimate with anyone as many of these STIs can spread through other ways. You can further spread the infection to your partner unknowingly.

References

• Pfizer. 8 Common STDs: What You Need to Know. https://www.pfizer.com. Accessed on 06/03/2024
  
• World Health Organization. Sexually transmitted infections (STIs). https://www.who.int. Accessed on 05/03/2024
• Mayo Clinic. Sexually transmitted diseases (STDs) - Symptoms and causes. https://www.mayoclinic.org Accessed on 05/03/2024
• Mayo Clinic. HPV infections - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/hpv-infection/symptoms-causes/syc-2035196
• Mayo Clinic. Symptoms and Causes. https://www.mayoclinic.org/disease-conditions/gonorrrhea/symptoms-causes/syc-20351774#
• World Health Organization. Diagnosis and Treatment - Symptoms of Hepatitis C. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c? Accessed on 06/03/2024
• World Health Organization. Symptoms of syphilis - Syphilis and how it spreads. https://www.who.int/news-room/fact-sheets/detail/syphilis? Accessed on 05/03/2024
• Healthline. Hepatitis: What is it? Types, Symptoms, Causes and More. https://www.healthline.com/health/hepatitis#diagnosis
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• Yarber WL, Parrillo AV. Adolescents and sexually transmitted diseases. J Sch Health. 1992 Sep;62(7):331-8. doi: 10.1111/j.1746-1561.1992.tb01252.x. PMID: 1434562.