Back to Top Skip to main content Skip to sub-navigation

Sexually transmitted infections – you may have one and not know it

Infographic about STIs Service members with questions about protective measures like condoms, testing, or treatment, are encouraged to contact their medical provider or local installation public health nurse (Illustration by Graham Snodgrass, APHC).

Recommended Content:

Medical and Dental Preventive Care Fitness

During the past year, people have learned to protect themselves and their loved ones from COVID-19 by using three simple public health practices to prevent infection and decrease spread:

  • Maintain distance from potential sources of infection
  • Wear protection
  • Get tested

These same public health practices are similar to those recommended to protect us from other infections that are transmitted from person to person. This includes sexually transmitted infections, or STIs.

STIs include both sexually transmitted diseases, known as STDs, and the many infections that do not progress to disease. A 2021 National Academies Press report describes STIs caused by more than 30 organisms transmitted through skin- and fluid contact during sexual encounters. The report emphasizes promoting responsible sex to reduce transmission and focusing attention for high-risk groups such as the military.

Before falling into the trap of believing that STIs aren't something that may affect you personally, it's important to understand how common STIs are. The Centers for Disease Control and Prevention estimated that one in five people in the United States had an STI on any given day in 2018. STI rates have risen during the last six years, reaching all-time highs when last reported in 2019.

Symptoms can include pelvic, vaginal, or penile pain, inflammation, discharge or odors. Others may present as rashes, painful or painless sores or warts.

Yet one area of special concern are the many asymptomatic cases of STIs, which are people who don't have symptoms but are 'carriers' who can still transmit the infection to others. Many people, both men and women, fall in this category. In the absence of symptoms, those infected typically don't seek testing and treatment, which in turn increases STI spread.

For those who experience symptoms, effects can show up days, weeks, or even months after the exposure, said Maj. James Waters, a public health nurse and doctor of nursing practice in the Army Public Health Nursing Branch at the Army Public Health Center.

"Without treatment, long-term impacts can be serious and permanent," said Waters. "These can include infertility among men and women, chronic pain, increased risk of HIV, certain types of cancer, organ failure and potentially death. Untreated STIs can also be dangerous during pregnancy, both to the mother and her baby."

The NAP and CDC have identified the most commonly reported STIs to be chlamydia, gonorrhea and syphilis. Reporting these STIs is mandated because they are easily spread and there are effective treatment options to prevent serious health problems. While the CDC monitors these STI cases in the U.S. population, the Army's APHC tracks the cases among U.S. soldiers.

"In the U.S., 15-24 year olds account for almost half of these STIs," explains Nikki Jordan, a senior APHC epidemiologist and coauthor of a recent study "A Comparative Analysis of Reported Chlamydia and Gonorrhea Cases among Army Soldiers from 2015-2019." "Since approximately half of the Army is under 25, it is not surprising that soldiers represent a high-risk subgroup of the overall U.S. population."

Picture of a condom
Using a condom is one way to protect against sexually transmitted infections or STIs (Army courtesy photo).

Within the Army, like in the overall U.S. population, reportable STI rates have been increasing for the past several years. But when comparing rates between the U.S. and Army populations, Jordan notes the importance of accounting for age and sex differences. This is because the U.S. population includes all ages and is generally evenly split between men and women, whereas the soldier population includes more young adults and 85 percent are men.

Jordan's study found that after controlling for age and sex differences, Army soldiers' chlamydia rates were almost 2 times higher than the rates in U.S. adults. The U.S. adult gonorrhea rates, however, were about 1.35 times higher than the soldier rates. Similar to U.S. population data, soldier STI rates were highest among adults under 25 years, women, and some racial and ethnic minority groups.

"There are many reasons soldiers may have greater STI risk including increased travel, excessive alcohol use, and unique job-related stresses," said Jordan. "Cases may also be more likely to be detected among soldiers, because they have more healthcare access and STI testing than the general population."

Waters explains that the Department of Defense annual chlamydia testing, which often includes a full panel of tests for other STIs like gonorrhea and syphilis, is only required for women under 25 years of age. This is based on recommendations from the U.S. Preventive Services Task Force.

"Since most male Soldiers do not seek STI testing unless they or their partner are experiencing symptoms, we may not be identifying many cases among male soldiers, who can spread the infection to others. So the higher female STI rates we see in reported data may be due to their higher rates of testing," Waters said.

Waters explains that since a majority of these STIs are asymptomatic, prevention and control are challenging, because one cannot generally tell if a person has an STI.

"Those who are infected may not know - so they have a false sense of security, don't feel the need to practice safe sex, and continue to spread the infection," said Waters. "Very importantly, chlamydia, gonorrhea, and syphilis STIs can all be easily detected and cured with a limited course of antibiotics. However, recovery doesn't mean a person can't be re-infected. And there are increasing concerns of antibiotic resistance, especially after repeated treatments."

Recently, the Armed Forces Health Surveillance Division reported a notable decrease in STI rates in 2020. Jordan and her colleagues say this may be partly due to soldiers having fewer social contacts during the pandemic, and – hopefully - also smarter, safer sex practices. But they also point to a decrease in health care access, STI testing, reporting, and contact tracing in 2020.

"Many medical services were put on hold or diverted to support the COVID-19 response, so we don't really know yet if STI rates are actually starting to decrease," said Jordan. "Regardless of the data, we know we still miss a lot of asymptomatic cases, and that STIs continue to be transmitted by millions of Americans, including soldiers, who aren't aware they are infected. The pandemic pointed out weaknesses in the public health system. New solutions need to be considered - like internet-based testing with at-home test kits that are increasingly being used in the civilian sector."

"There are no vaccines for most STIs, including chlamydia, gonorrhea, and syphilis," adds Waters. But these STIs can be easily prevented, tested and treated.

Soldiers with questions about protective measures, like condoms, testing or treatment, are encouraged to contact their medical provider or local installation.

You also may be interested in...

The HPV Vaccine Saves Lives

Infographic
5/16/2016
The Defense Department recommends male and female military service members, ages 17-26 years, receive an HPV vaccine series to generate a robust immune response to the quadrivalent human papillomavirus vaccine (HPV4). This graphic highlights information the benefits of the HPV vaccine. The vaccine is most effective among fully vaccinated individuals.   Cancer Prevention Facts •	HPV is the most common sexually  transmitted infection (STI) •	There are more than 40 HPV types that can infect the genital areas •	Some HPV types give warts •	Some HPV types develop cancer  Effective Against STI Transmission •	The HPV vaccine is a safe and effective way to protect yourself from the virus •	The HPV vaccine provides nearly 100% protection from HPV types 6,11,16 and 18 •	HPV vaccine shows early signs of success in reducing HPV infections and related illnesses •	Protection is expected to be long-lasting  Safety Tips •	Getting your HPV vaccine and practicing safe sex such as wearing a condom may lower the risk of HPV •	Limiting the number of lifetime sex partners can also lower the risk of HPV •	When given the HPV vaccine, the body makes antibodies in response to the protection to clear it from the body  Get the Facts •	2,091 female service members aged 17-26 years received 1-3 HPV4 doses during 2006-2012, stratified by number of doses (1, 2, or 3).  Get the HPV Vaccine •	Only 22.5% of eligible service members initiated the series •	Of those, only 39.1% completed the full three-dose series as of June 2011.  Even though the 3 dose regiment provides nearly complete protection against HPV16 and HPV18, in the U.S., only 12% and 19% of female adolescents among commercial and Medicaid plans respectively complete the series.  Read HPV Facts from the CDC: https://www.ok.gov/health2/documents/IMM_Teens_HPV_Facts.pdf  Read the STI issue of the Medical Surveillance Monthly Report at Health.Mil/MSMR   Get the conversation started. Ask your healthcare provider about the HPV vaccine today. Follow us on Twitter @AFHSBPAGE and use hashtag #VaccinesWork.

The Defense Department recommends male and female military service members, ages 17-26 years, receive an HPV vaccine series to generate a robust immune response to the quadrivalent human papillomavirus vaccine (HPV4).

Recommended Content:

Medical and Dental Preventive Care Fitness | Immunizations | Men's Health | Human Papillomavirus | Armed Forces Health Surveillance Division | Women's Health

Study Finds Strong Immune Response to HPV Vaccine Among Female Service Members

Report
5/11/2016

A new study of female service members that examined their immune response to a vaccine to combat the sexually transmitted virus that causes cervical cancer showed development of antibodies in 80 to 99 percent of recipients against each of the four strains of the disease.

Recommended Content:

Health Readiness | Armed Forces Health Surveillance Division | Public Health | Armed Forces Health Surveillance Division | Medical and Dental Preventive Care Fitness

Breast Cancer

Infographic
5/9/2016
infographic about the breast cancer and how to protect against it.

In the U.S., with the exception of skin cancer, breast cancer accounts for the greatest number of cancer diagnoses in women and the second most common cause of female cancer-related deaths. This infographic shows seven ways to protect yourself from breast cancer.

Recommended Content:

Medical and Dental Preventive Care Fitness | Women's Health

Breathing techniques

Photo
2/26/2016
Airmen and Soldiers practice breathing and relaxation during their off duty time in a deployed location. Stress can take its toll on your mental and physical health, including your heart health, but there are breathing techniques to buffer yourself from it. (U.S. Air Force photo by Master Sgt. Lance Cheung)

Airmen and Soldiers practice breathing and relaxation during their off duty time in a deployed location. Stress can take its toll on your mental and physical health, including your heart health, but there are breathing techniques to buffer yourself from it. (U.S. Air Force photo by Master Sgt. Lance Cheung)

Recommended Content:

Medical and Dental Preventive Care Fitness | Psychological Fitness

Practice Healthy Living Habits

Infographic
1/19/2016
Infographic listing 5 key healthy habits for the new year

A list of healthy living habits you can take on in 2016.

Recommended Content:

Total Force Fitness | Nutritional Fitness | Physical Fitness | Tobacco-Free Living | Medical and Dental Preventive Care Fitness

Cervical Health Awareness Month

Infographic
1/11/2016
Infographic about Cervical Health Awareness month

January is Cervical Health Awareness Month

Recommended Content:

Women's Health | Medical and Dental Preventive Care Fitness

Preventive Health Tip 4

Infographic
8/24/2015
Preventive Health Tip #4: Healthy Dental Habits

Encourage your child to practice healthy dental habits

Recommended Content:

Medical and Dental Preventive Care Fitness | Children's Health

Preventive Health Tip 3

Infographic
8/17/2015
Preventive Health Tip #3: Healthy Snacks on Hand

Avoid obesity--keep a variety of healthy snacks on hand.

Recommended Content:

Medical and Dental Preventive Care Fitness | Children's Health

Preventive Health Tip 1

Infographic
8/1/2015
Preventive Health Tip for Back to School

Ensure your child has the recommended vaccinations and be aware of changes.

Recommended Content:

Medical and Dental Preventive Care Fitness

DoD Instruction 1010.10: Health Promotion and Disease Prevention

Policy

This instruction reissues DoD Directive (DoDD) 1010.10 (Reference (a)) as a DoD instruction (DoDI) in accordance with the authority in DoDD 5124.02 (Reference (b)) to establish policy and assign responsibilities for health promotion and disease prevention in accordance with References (c) through (f).

<< < ... 6 > >> 
Showing results 76 - 85 Page 6 of 6

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.