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."