As a Gen Xer whose adolescence coincided with the AIDS epidemic, I am concerned to learn that HIV and other sexually transmitted diseases or infections (STIs) are on the rise across Iowa. (I’m using the term STI throughout the article, but some of my sources use the term STD.) According to data collected by the Iowa Department of Health, there’s been a 55 to 75 percent increase in syphilis cases, and a general rise in other STIs. I feel like I should be channeling Annie Potts’s character in Designing Women and handing out condoms. So as your friendly neighborhood journalist and honorary auntie, I will be sharing tips for safer sex.
I was lucky to receive excellent sex ed in Seattle in the mid 1980s, before moving to Iowa. Unfortunately for the rest of my Iowa classmates, the school administrators believed the common fallacy that teaching teens about sex leads to greater promiscuity, so sex ed was fairly lacking in my high school years. (Statistically, teens who’ve had sex ed actually wait longer to start exploring sex and also engage in less risky behaviors.) I made school history by delivering a speech on common STIs and safe sex practices in our Junior Toastmasters class my senior year, so it only makes sense that I feel compelled to share some sex education now.
Combatting the social stigma around STIs or STDs is an important part of good sex education. “STDs are very common and do not define who a person is,” says Francine Thompson, director of the Emma Goldman Clinic in Iowa City. “The stigma is bigger than the disease and [STDs are] a risk for anyone, not just some, regardless of sexual history. We encourage honest, informed conversations with all sexual partners in an effort to help lessen stigma as well as risk.”
Thompson explains, “Disinformation leads to higher transmission rates and complications with untreated STDs. Since it is quite common for an infected person to have no symptoms, it’s easy for someone to contract or spread an STD without their knowledge.”
Local hospitals, health clinics, and Planned Parenthood all provide STI screening and treatment. According to Thompson, the Emma Goldman Clinic routinely discusses safer sex practices with their clients, covering “consent, condoms, routine testing, and information about the risks and route of transmission of specific STDs, as well as birth control options for those interested.” They also offer educational handouts and discuss “transmission, treatment, and how to have a conversation with your partner(s) about reducing risk or getting a positive test result.” Don’t be afraid to talk to your current love interest about sexual health. “Good communication with potential, new, and current sexual partners is ideal,” Thompson adds.
The good news is that STIs are preventable, and when caught soon enough, treatable. Obviously, refrain from bedroom activities until things are cleared up. Condoms, internal (sometimes referred to as “female”) condoms, and dental dams all reduce the risk of STI transmission. And for the latex sensitive, there are a number of latex-free options, using polyurethane (a thin plastic), or polyisoprene (a synthetic rubber without latex’s allergenic proteins).
Please note, while lambskin condoms are latex free, and hold up to oil-based lubricants (oil breaks down latex, making latex condoms more likely to tear), THEY DO NOT PREVENT STI TRANSMISSION. Their membrane is too porous, and lets bacteria or viruses through, while trapping sperm. Lambskin condoms are only good for birth control.
STIs are spread through sexual contact, which includes all forms of sex: oral, vaginal, and anal, or through shared sex toys. Oral herpes can be passed on through kissing. Common STIs include:
Syphilis: A bacterial infection, syphilis spreads through person-to-person contact with a syphilitic sore, called a chancre, during sex. The chancre goes away, but a rash later develops in its place. Pregnant women with syphilis can transmit the infection to their unborn child. Syphilis has three stages, and can go latent for years. The tertiary stage can affect the brain, nerves, and vital organs, and is fatal if left untreated. Luckily, there are a number of effective treatments available.
Chlamydia: In 2019, nearly 2 million cases of chlamydia were reported to the CDC. The most common STI, nationwide and in Iowa, chlamydia is a bacterial infection that can cause infertility if untreated. As it’s often asymptomatic or has very mild, UTI-like symptoms, getting regular STI testing if you’re sexually active is important. An antibiotic regime will clear it up.
Bacterial Vaginosis (BV): BV develops when vaginal internal flora, fauna, and pH are off, allowing for bacterial overgrowth, which can be transferred to a partner during sex. So if your nether regions smell like dead fish, don’t have sex and see your doctor for a diagnosis. BV generally responds well to antibiotics. Probiotic therapy may also help prevent recurrences.
Genital Warts: According to the Planned Parenthood website, genital HPV (human papillomavirus) causes wart growth in and around the genitalia and anus. HPV is spread through skin-to-skin contact. An estimated 360,000 people get HPV every year. HPV can be removed at a hospital or clinic. Over-the-counter medicines for warts on your hands or feet should not be used to treat genital warts.
There is an HPV vaccine that prevents most kinds of genital warts and certain types of cancer.
Gonorrhea: Sometimes called “the clap” or “the drip,” gonorrhea is spread through all kinds of sex. The bacteria is carried in sexual fluids. Gonorrhea is often asymptomatic. It can be cured with antibiotics, but if not caught early enough, can lead to serious health problems in the future.
Herpes: A viral infection caused by herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2), herpes causes outbreaks of itchy, painful blisters or sores that come and go, wherever there has been skin-to-skin contact with infected areas during sex or kissing. People often call active oral herpes cold sores or fever blisters. According to Planned Parenthood, over half of Americans have oral herpes, and about 1 out of 6 Americans has genital herpes. While there is no cure, there is medication to manage symptoms, reduce outbreaks, and lower the possibility of transmitting the infection to someone else.
HIV and AIDs: The Human Immunodeficiency Virus (HIV) attacks CD4 cells or T cells, which fight off infections, thereby making the body much more vulnerable to illness. If untreated, HIV leads to Acquired Immune Deficiency Syndrome, or AIDS. Contained in sexual fluids, anal mucus, blood, and breast milk, HIV is transmitted through sex, shared needles or syringes, or open cuts or sores. HIV is not transmissible through kissing or sharing food.
According to Planned Parenthood, there are around 1.1 million people in the U.S. with HIV, and over 38,000 new infections every year. Most people with HIV are asymptomatic for a few years before the immune system starts to have problems. There are a number of frankly miraculous medical treatments now that radically improve HIV patients’ quality of life while significantly reducing the risk of transmission. HIV infection no longer means automatically getting AIDS and having a terrifyingly short life expectancy. Many patients have no viral load to speak of. There’s also a prescription med, pre-exposure prophylaxis (or PrEP), which makes it harder to contract HIV. According to the CDC, PrEP reduces the risk of getting HIV from sex by about 99 percent, and reduces the risk of getting HIV from injection drug use by at least 74 percent.
Trichomoniasis (trich): caused by a microscopic protozoa, millions of people get trich every year. The parasite is carried in sexual fluids, and symptoms include smelly discharge, irritation, and frequent urination. Trich is very easy to treat.
Hepatitis B: A viral infection that causes liver damage, Hepatitis B is spread by exposure to infected body fluids, through sex, or exposure to contaminated blood. It can also be passed from mother to child during pregnancy and is often asymptomatic. While many cases resolve on their own, some infections become chronic, leading to liver failure and cancer. Chronic cases are treated with antivirals and meds to help manage symptoms. There is a highly effective vaccine to prevent Hepatitis B.
PID: Pelvic Inflammatory Disease, or PID, is a bacterial infection of the uterus, fallopian tubes, and ovaries, caused by untreated chlamydia, gonorrhea, or other infections, like BV. PID increases the risk of ectopic pregnancy, and often causes chronic pain and infertility. It is treatable.
Pubic Lice: Also known as “crabs,” pubic lice are blood-sucking parasites resembling tiny crabs, generally found in the pubic area, though they’re sometimes found in other coarse body hair, such as underarms or eyebrows. They’re spread through sexual contact, close personal contact, or contact with contaminated clothing, bed linens, or towels. You can’t get them from toilet seats. There are both prescription and over-the-counter lotions for killing off pubic lice, as well as cleaning and isolation regimes that are similar to that of dealing with head lice.
According to the CDC, 1 in 5 people in the United States had an STI on any given day in 2018. So it’s time to treat STIs like any other common problem. While medically underserved communities are more vulnerable, STIs can happen to anyone, regardless of age, race, sex, gender, or paygrade. Talkng about your sexual histories and making safer sex practices fun can lead to greater intimacy, which can actually improve relationships. Communication, safer sex practices, and access to medical services are key to preventing, curing, and treating STIs. With proper diagnosis and treatment, people with STIs still lead happy, healthy, emotionally rich, and sexually satisfying lives.
For more information, visit these online resources:
Iowa Department of Public Health