Manageable Sexually Transmitted Infections
An STI diagnosis is not the end of your sex life
April is STI Awareness Month, so what better time to talk about STIs to normalize them and remove some of the stigma and shame.
STIs are sexually transmitted infections (also known as STDs - sexually transmitted diseases), and they are spread through close contact with another person and/or their bodily fluids. There are many different STIs, but all STIs are either curable or manageable. Curable STIs are ones where you can take antibiotics or some other form of medication (typically prescribed by a doctor), and it will clear them up. Manageable STIs have no cure, so once contracted, they will remain with you throughout your life. Still, there are remedies, medicines, and lifestyle practices to make living with them not detrimentally impact your life.
Manageable STIs typically hold the most shame and stigma within our society, so it is important we understand the facts before adding to false narratives. Manageable STIs include herpes (HSV), HIV, and HPV. So, let’s take time to explore each one.
Herpes
HSV is the herpes simplex virus and manifests as either oral herpes, commonly referred to as cold sores, or genital herpes. Herpes is one of the most common manageable STIs, with over 80% of the global population having herpes. There are two strains of herpes, HSV-1 and HSV-2. HSV-1 is most common as oral herpes.
Herpes looks different for everyone because some individuals never experience an outbreak, rarely do, or may be asymptomatic. On the other hand, some individuals may experience outbreaks one to three times a year, and others may have more frequent outbreaks. For folks who have experienced an outbreak or experienced multiple outbreaks, there is medicine to manage symptoms of an outbreak or minimize the occurrence of outbreaks. The most common medications are acyclovir, famciclovir, and valacyclovir.
Managing Herpes
Managing herpes within sexual relationships can feel more intimidating because herpes can be spread in two ways: (1) during an outbreak if there is contact and (2) during asymptomatic shedding. Asymptomatic shedding is when the virus is present on the body's skin, but there are no symptoms, making it easier to transmit the virus without knowledge. The only way to know you are asymptomatic shedding will be if you are continually swabbing the area to see if the virus is present. To minimize transmission, it is recommended to use barrier methods with partners. Dental dams work really well as they cover more surface area and can be used during oral sex. You can use a dental dam for both the vulva and the anus, whether you have genital herpes or oral herpes. For penetrative sex, condoms work, but it is important to be mindful that condoms don’t cover the skin around the genitals.
HIV
HIV is a virus that attacks your immune system. It is spread through sexual activity, such as anal or vaginal sex. It can also be spread from other non-sexual activities, including sharing needles and other drug injection equipment and coming in contact with the blood of someone who has HIV.
Managing HIV
There are three options to manage HIV: Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and Antiretroviral Therapy (ART).
- PrEP is taken before potential exposure to HIV from someone who already has the virus.
- PEP is taken after a potential exposure to HIV, and it must be taken within 72 hours after the exposure.
- ART is a treatment plan that works to minimize the viral load of HIV in a person’s body. Proper following of ART can lead to viral suppression resulting in HIV being undetectable in someone, meaning it is less likely to be transmitted.
Between the three different medications/treatments and the use of barrier methods, the risk of transmitting/contracting HIV is much lower, so people can engage in happy, sexual fulfilling lives. The most challenging component of managing HIV is dealing with societal shame and stigma. There are so many false and negative beliefs about HIV, mainly it being a “gay disease.” This is not true by any means. Anyone can contract HIV, and it does not just impact one demographic of people based on their sexual orientation. We can manage this stigma around HIV by educating people about what HIV truly is and how anyone can contract it.
HPV
HPV, which is Human Papillomavirus, is the trickiest manageable STI for a number of reasons. It is actually the most commonly transmitted STI in the United States. HPV is only testable on people with vulvas, cervixes, and a uterus. The only way to test for HPV is during a pap smear exam, where the cervix is swabbed, and the cells are examined to see if HPV is present. Since HPV is only tested via a pap smear, men and people with a penis cannot be tested for it. Most men who contract HPV never have symptoms, which is why it is so commonly transmitted. Untreated HPV or HPV that does not go away on its own can lead to genital warts or different forms of cancer.
Managing HPV
When it comes to managing HPV, regularly getting pap smears is important. Talk with your doctor about how often you should be getting pap smears. It may be annually or spread out over three-year timespans depending on previous pap smear results. Another way to manage the spread of HPV is through prevention. The vaccine for HPV, called Gardasil, is recommended for 11 to 12-year-olds, but it can be given to individuals up to age 45. If you are a parent, you should talk further with your child’s doctor about the vaccine for them getting it. And the easiest way to manage the spread of HPV is using barrier methods, of course.
An STI diagnosis can be overwhelming but know that you are not alone, and they are a lot more common than popular narratives make it seem. Regardless of the diagnosis, all STIs are curable or manageable, and they don’t have to be the end of a happy and fulfilling sex life!
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