“If STDs are so common, why do I know so many people who have sex but don’t have an STD?”

Only a handful of people have ever told me that they have or had an STD. In most of those cases, very few people knew. I couldn’t blame them. If I got an STD, I wouldn’t really want to talk about it either. One young woman explained to me that she felt very alone and ashamed. She would sit next to her friends in school and they would talk about some other person who had an STD, and all the while this girl was thinking, “What would they say about me if they knew that I had one?” I wondered if any of her friends were thinking the exact same thing but wouldn’t admit it. The sad fact is, STDs are far more common than anyone wants to admit, so outside of statistics, we rarely hear about them. But that doesn’t mean that they are not around.

“Can I get an STD just by kissing someone?”

I’m afraid so! But the risk depends on how the specific disease is transmitted. For instance, HIV is rarely passed by kissing, but if someone had a cut or sore in their mouth, they could become infected. Other diseases that are passed through skin contact with the infection, like herpes and syphilis, are more easily contracted from kissing. Symptoms don’t have to be noticeable to transmit a disease. So while the risk might be lower compared to the risk of getting a disease through genital contact, it is still there.

“Is it possible to have an STD and not know?”

Many of the more common STDs do not show symptoms in the early stages. Genital herpes is one example. According to the CDC (Centers for Disease Control and Prevention), once infected, many people don’t notice any signs or symptoms – sometimes they can be so mild they go unnoticed, or they are mistaken for something else. The problem is, the disease could be passed on long before it is ever noticed. More than 1 in 6 of all people ages 14 to 49 in the U.S. are infected with the virus that causes genital herpes, but as many as 90% don’t know it. The problem is that asymptomatic herpes carriers shed the virus 10% of the time, and can infect others they have sexual contact with. Other diseases simply affect the internal genital organs more than the external ones. Chlamydia is notorious for remaining undetected for months, or even years, and sometimes someone born female doesn’t know she has it until someday she finds out she has pelvic inflammatory disease and is dealing with infertility (can’t have kids). The only true way to know if you an STD is to get tested. BUT be aware that there is no available test for some STDs, so even a “clean” result from testing a sexually active person is no guarantee you don’t have an STD. In fact, there is no available test to see if a guy has HPV…the most common viral STD…the one that can cause genital or oral warts or worse…cervical, anal, penile, or oropharyngeal cancers.

“Could I have gotten an STD when I was born, so that I have it even though I’m a virgin?”

While it is possible to contract an STD at birth, the CDC identifies a number of serious consequences of a child contracting an STD through birth. In many cases, the infant is not likely to survive very long. When survival is possible, it seems to depend on quick identification and treatment of the disease. That means that it would be very unlikely for someone born with an STD to live very long without discovering that they had it. So you probably wouldn’t be walking around with an untreated STD that you’ve had since birth – you would have noticed it long ago!  (Beware! If you are technically a virgin, but have been sexually active in other ways – anal, oral, touching privates – you can still get STDS.)

“I got Chlamydia from my boyfriend and got treated. Is it possible to get it again?”

Unfortunately, yes, it is possible to become infected with the same the STD more than once, especially if only one partner is being treated. I spoke with the young woman who asked this question, and she said that she “thought” her boyfriend had been treated as well, but she wasn’t sure. He had cheated on her – that’s how he got the STD and passed it on – and she didn’t know if she could trust him now. Furthermore, even if he got treated, if he cheated on her again, he could become reinfected and so could she. To reduce her risk of becoming reinfected, she should stop having sex with her boyfriend. (In addition to protecting her from the disease, abstaining would also help her evaluate the quality of their relationship.)

“I’ve been told condoms can protect me from getting STDs. Isn’t that true?”

Condoms are better at reducing the spread of some types of STDs, like HIV and gonorrhea, because they are spread by bodily fluids. Condoms are a barrier method and the idea is that if the condom doesn’t break, slip or leak, fluids won’t get in or on each other. But other STDs are spread by skin-to-skin contact, and you can’t count on condoms protecting you from those. The CDC says, with regard to ulcerative diseases (like herpes and syphilis), and HPV: “Genital ulcer diseases and HPV infection can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered.”

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