Published on June 08, 2018

Are you putting yourself at risk for STDs?

Are you putting yourself at risk for STDs?

Having unprotected sex puts you at risk of a sexually transmitted disease (STD), and that risk is growing.

Cases of STDS have proliferated in recent years, according to the Centers for Disease Control and Prevention. Consider the CDC’s most recent statistics on three STDs, from a 2016 report on changes from the previous year:

  • Chlamydia – 1.59 million cases, up 4.7 percent;
  • Gonorrhea – 468,514 cases, up 18.5 percent;
  • Syphilis – 27,814, up 17.6 percent

“The key to prevention with a new partner – always use condoms,” said Nisha David, MD, a obstetrician and gynecologist at Falmouth Hospital. “And get tested first.”

cdc std infographic

UPDATE: On August 28, 2018, during this year’s annual STD Conference, the CDC announced that new data show steep, sustained increases in STDs. Specifically, nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017, according to preliminary data released by the Centers for Disease Control and Prevention (CDC) at the National STD Prevention Conference in Washington, D.C. This surpassed the previous record set in 2016 by more than 200,000 cases and marked the fourth consecutive year of sharp increases in these sexually transmitted diseases (STDs). To learn more, please visit the CDC Newsroom.

The CDC identifies teens and young adults, gay and bisexual men and pregnant women as at-risk populations for STDs, but older Cape residents aren’t immune, Dr. David said.

“Older patients can be at risk because they’re not worried about pregnancy” and so don’t use birth control, namely condoms, she said.

The CDC statistics highlight chlamydia, gonorrhea and syphilis because those infections are required to be reported to the government agency, not because they’re necessarily the most common STDs. That distinction belongs to human papillomavirus, or HPV, a group of about 40 virus strains, some of which cause no symptoms, but others that result in venereal warts and cancers of the genitals, anus and throat.

“HPV is far and away the most common,” Dr. David said, adding that some estimates claim 90 percent of women are infected with HPV.

“Condom use will help prevent it,” she said. “It’s so ubiquitous. Anyone sexually active without a condom will probably get it.”

[RELATED: Many sexually active teens avoid HIV testing]

Dr. David recommends that parents have their children vaccinated against HPV between ages 9 to 12, before they are sexually active. At that point the vaccine creates a stronger immune response than when given to young adults.

Genital Herpes and Hep C

The next two most common STDs Dr. David sees in her practice are genital herpes and hepatitis C.

“Unfortunately, Hep C is really common on the Cape,” she said, attributing the infection rates to intravenous drug use.

Sharing hypodermic needles is how it’s typically spread, according to the CDC. However, sexual partners of infected IV drug users can contract the virus.

Hepatitis C can go unrecognized and become a chronic, long-term infection causing serious liver damage, even death. There is no vaccine, so prevention requires avoiding injecting drugs and unprotected sex. Massachusetts had the highest state rate of reported acute cases in 2015: 3.7 per 100,000, compared with a national average of 0.8 per 100,000, according to the CDC.

Dr. David said she screens all her patients for Hepatitis C.

Genital herpes is caused by two strains of the herpes simplex virus, one that commonly causes cold sores or fever blisters around the mouth and the other that typically afflicts the genitals. The strain that causes outbreaks on the face can be spread to genitals during oral sex. It can also be passed from a mother to her baby during birth.

Though some infected people experience outbreaks of blisters and sores, others don’t have these symptoms or have very mild symptoms and don’t realize they’re infected. There is no cure. Condoms can help lower the risk of transmission, but may not prevent it, according to the CDC. The agency estimates that more than one in every six people aged 14 to 19 have genital herpes.

Other STDs to Worry About

Dr. David said she also often sees chlamydia and trichomoniasis in her practice. Chlamydia can damage a woman’s reproductive system so that getting pregnant becomes difficult or impossible. Some women with chlamydia may not seek treatment, as symptoms of pelvic pain and vaginal discharge may come and go, or they may have no symptoms, she said.

Men may have a penile discharge and discomfort and swelling in their testicles, according to the CDC. Both men and women may get symptoms of painful urination or rectal discharge and bleeding. The disease also can be spread to an infant during birth and cause the child to develop an eye infection or pneumonia.

Dr. David said her practice follows American College of Obstetrics and Gynecology guidelines and screens every patient annually for chlamydia if they’re under 25 and sexually active, or older and have new sex partner or partners, or have another STD. The same guidelines apply to gonorrhea. The CDC recommends that sexually active gay and bisexual men also get tested for chlamydia. The disease can be treated with antibiotics.

Less routinely seen in her practice is gonorrhea, for which Dr. David said she screens patients at the outset of pregnancy. Like chlamydia, gonorrhea can cause pelvic pain, ectopic pregnancy and infertility in women. It can be treated with antibiotics, but it is becoming resistant to these drugs.

This bacterial disease hit a recorded low in 2009, but its rate of occurrence has risen from 98.1 per 100,000 that year to 145.8 per 100,000 in 2016, the CDC reported. The agency said factors that may be affecting this increase may include changes in screening and reporting.

Dr. David’s patients are all women, whom, she said, tend to see healthcare practitioners more often than men. She urged men to get regular checkups and screenings for STDs.

“We see women, ideally every year, for pap smears (looking for indications of cervical cancer), or see them for contraception,” she said. “Men don’t have as many checkpoints.”