Sexually Transmitted

Infections or Diseases
(STIs or STDs)
Last updated: June 27, 2025

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 The Basics

Sexually transmitted infections: Infections

passed from person to person through sexual
contact
• HIV is an STI
• More than 25 STIs
mainly spread by
vaginal, anal, and
oral sex
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 The Basics

• World Health Organization (WHO): more than 1

million STIs acquired every day worldwide
• STIs are similar to, but not the same as, STDs
– Most people with STIs do not have any symptoms
• Often don’t know they can pass infection on
– Left untreated, STIs can cause serious problems:
• Cervical cancer
• Liver disease
• Pelvic inflammatory disease (PID)
• Infertility
• Pregnancy problems
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 The Basics

• Having some STIs can increase risk of acquiring

HIV if you are HIV-negative and get exposed to HIV:
– Chancroid
– Herpes
– Syphilis
– Trichomoniasis
• People living with HIV may also be at greater risk
of getting or passing on other STIs
• People living with HIV often experience more
serious problems if/when they get STIs
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 The Basics

US has highest rate of STIs in resource-rich world

• About 26 million new infections in 2018
• Almost half among young people (15-24 years old)
– more at risk for STIs than older adults because:
– Young people’s cervical cells more vulnerable to STIs
– Teenagers, young adults may have problems getting
information, services, supplies they need to avoid STIs
• May have trouble getting STI prevention services
• May not feel comfortable in places designed for adults
• May have concerns about confidentiality

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 The Basics

Teenage girls and women of color have some of the

highest rates of STIs – especially chlamydia,
gonorrhea
• Several factors:
– Higher rates of poverty
– Less access to health care
– Already high rate of STIs
in communities of color
• Increases risk of getting an STI each time a woman has sex
• Sexual partner in community is more likely to have an STI

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 The Basics

• Regardless of race or age, less than half of those

who should be tested for STIs receive screening
– Especially important for women
– More frequent/serious complications from STIs than men
• STIs without symptoms can still be transmitted
– Many people who have an STI do not know it
– Only way to know for sure is regular STI screenings
• STIs can be prevented by practicing safer sex
• STIs can be cured or managed with treatment

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 The Basics

• Many people with STIs have no or symptoms

– When there are signs of STIs, likely to be in genital area
– For cisgender women, this includes:
• Vulva (area around vagina including lips)
• Vagina (opening where menstrual blood comes out)
• Buttocks
• Urethra (opening above vagina where urine comes out)
• Anus (opening where bowel movement – “poop” – comes out)
– For cisgender men, this includes:
• Penis
• Scrotum (“balls”)
• Urethra (tube through which urine passes through penis)
• Anus
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 Chlamydia
• Among most common STIs
• Caused by bacterium in genital tract
– Including vaginal secretions, semen
– Also infections in throat and rectum (“butt”)
• Can be spread by:
– Vaginal, oral, or anal sex without a barrier
– Pregnant people can pass it on to babies during delivery
• Symptoms may include:
– Vaginal discharge
– Burning during urination
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 Chlamydia
• Can be successfully treated with antibiotics
– Left untreated, can spread to ovaries and fallopian tubes, cause
pelvic inflammatory disease (PID)
– PID can lead to infertility, make it difficult to become pregnant
– Can cause infection in butt (rectal pain, discharge, bleeding)
• Yearly screening recommended by CDC for:
– All sexually active women under 25
– Older women with new or multiple sex partners
– Recent reports show fewer than half of sexually active women under
25 are screened
– Ask for test, if not offered by provider
• If treated, partner must be treated, too
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 Genital Warts

• Caused by viruses
– HPV (Human Papillomavirus) is large group of viruses
– Certain types of HPV cause infections in genital area
• Genital warts, cancer of cervix, vulva, vagina, anus, penis
• Genital HPV is spread easily:
– Skin-to-skin contact during vaginal, oral, or anal sex
• Condoms do not entirely prevent transmission
– People living with HIV more likely to have HPV, develop
genital warts, cervical or anal cancer

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 Genital Warts

• Important to find HPV early and get treatment to

prevent health problems
• Also three effective HPV vaccines
– # of girls with HPV has dropped significantly
• Best to get vaccinated before ever having sex
(before being exposed to HPV)
– Vaccines may not help people already infected
– But vaccines may protect against different HPV strains
• Recommendation: people living with HIV be
vaccinated up to age 45.
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 Gonorrhea (“The
Clap”)
• Caused by bacterium in vaginal secretions, semen
• Can be spread by:
– Vaginal, anal, oral sex without condom or
latex/polyurethane barrier
• Symptoms may include:
– Yellowish or greenish vaginal discharge
– Burning feeling when urinating
– Pain, discharge, bleeding in butt
– Itchy or persistent sore throat
• Can be treated with antibiotics
– Left untreated, can cause PID, infertility
– Request test if not offered by provider
• If treated, partner must be treated, too
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 Herpes

• Caused by a virus in nerves; two common types

– Herpes simplex type 1 causes cold sores around mouth
– Herpes simplex type 2 causes sores in genital area
– Possible to get HSV-2 in mouth, HSV-1 in genital area
• Symptoms include itchy or painful blisters
• Spread through skin-to-skin contact with sores
– May also spread even before sores can be seen
– In most people, sores come and go; virus stays in body
for life

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 Herpes
• Sometimes no symptoms; virus "hiding" in nerves
– Some women living with HIV never had blisters or sores before
acquiring HIV; surprised by "outbreak" of sores
– Women living with HIV may have more frequent difficult to treat
outbreaks
• No cure; antiviral drugs can:
– Reduce # of outbreaks if taken daily
– Shorten and ease outbreaks if taken when symptoms begin
– Valtrex also shown to lower transmission risk
• Pregnant people can transmit herpes to babies
– Tell your provider if you have genital herpes and are pregnant or
planning pregnancy
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 HIV

• HIV stands for Human Immunodeficiency Virus

– Virus that causes AIDS
• Is in blood, vaginal secretions, semen, breast milk
• Can be spread through vaginal, oral, or anal sex
without condom or treatment-as-prevention method
• Getting tested for HIV is part of routine, regular
health care in many countries
• Different testing recommendations for different
areas of the world
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 HIV

• Important that you get tested if you:

– Have ever had vaginal, anal, or oral sex without a condom
– Have shared needles, syringes to inject drugs, other substances
– Are uncertain of partner’s HIV status; have a partner living with HIV
– Are pregnant or are considering becoming pregnant
– Have ever been diagnosed with an STI or STD
– Have hepatitis C
– Begin treatment for tuberculosis (TB)
• HIV drugs
– Help people living with HIV stay well
– Can prevent people from acquiring HIV (PrEP)
• Cannot transmit if undetectable viral load (U=U)
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 Syphilis

• Caused by bacterium
• Can be spread by:
– Vaginal, anal, or oral sex without condom or other barrier
• Has several phases:
– Primary syphilis (early disease): pain-free open sores
(chancres) in genital or anal area or around mouth
• Usually heal on their own in 3-6 weeks
– Secondary syphilis (later stage): rash and/or hair loss

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 Syphilis

• Can be successfully treated with antibiotics

• Left untreated, can proceed to latent stage
– No symptoms, but damage to heart, brain, eyes, etc.
• Longer-term: neurosyphilis
– In brain or spinal cord -> can cause dementia, strokes
• Pregnant people can pass syphilis to their babies
during pregnancy and childbirth
– Important that pregnant people get tested for syphilis
• If treated, partner must be treated, too
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 Other STIs to Know
About
• Chancroid
• Hepatitis
• Pubic Lice (“Crabs”)
• Trichomoniasis

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 Chancroid

• Caused by bacterium
• Symptoms may include:
– Genital sores
– Vaginal discharge
– Burning feeling when urinating
– Swollen lymph nodes in groin
• Can be spread by:
– Vaginal or anal sex
– Skin-to-skin contact with sores Credit: [Link]

• Can be treated with antibiotics

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 Hepatitis
• Inflammation (irritation) of liver
• Some types of hepatitis caused by viruses in blood,
vaginal secretions, semen, breast milk
– Hepatitis B (HBV), C (HCV) can be sexually transmitted
– Can become chronic (long-term), very serious
– May have no symptoms
• Vaccine to prevent HBV
• Cure for HCV
• People living with HIV should be tested and treated
for HBV, HCV
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 Pubic Lice (“Crabs”)
• Live in pubic hair (hair around genitals)
• Can be transmitted by:
– Skin-to-skin contact
– Infected clothes and bedding
• Symptoms may include:
– Intense itching
– Seeing lice or eggs in hair
• Can be treated with Credit: Jennifer2016 on Glogster

over-the-counter medications
– Pregnant people must use products designed just for them
– Wash contaminated clothes, linen in hot water, laundry soap
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 Trichomoniasis
• Caused by protozoa (single-celled germ)
• Can be spread during vaginal, oral, or anal sex
without a condom or latex/polyurethane barrier
– Common cause of vaginal infections
• Symptoms may include:
– Foamy, foul-smelling vaginal discharge
– Itching
– Sometimes there are no symptoms at all
• Can be successfully treated with antibiotics
– Sexual partner must also be treated

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 Protecting Yourself
and Others
You can greatly reduce risk of getting many STIs:
• Use a latex or plastic condom for vaginal and anal sex
– Female condom can also prevent many STIs
– Use condoms without lubricant for oral sex on a man
• Use latex or plastic barriers (dental dams, plastic wrap) for
oral sex on a woman or for oral-anal sex; use latex or
plastic gloves if you have cuts or sores on your hands
• Use water-based lubricants with latex barriers
• DO NOT use oil-based products
• Do not use lubricants or condoms that contain nonoxynol-9
(N-9)
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 Protecting Yourself
and Others
• Wash shared sex toys or use fresh condom between users
• Use a latex condom with methods of birth control that do
not protect you from STIs
• Talk with your sex partner(s) about STIs and condoms
• Talk honestly with your provider, sex partner(s), about any
STIs you or your partner has or has had
• Have regular pelvic exams, cervical cancer screenings
• Talk to your provider about having a routine STI screening
• DoxyPEP has been shown to prevent bacterial STIs
• Do not share needles or syringes for injecting drugs or
other substances
– If you do share drug equipment, clean your works
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 The Bottom Line

• There are many STIs, including HIV

• Some can be cured; many can be managed
– Many can cause serious health and fertility
problems or even death if untreated
• If needed, get treatment your provider recommends
• Even if symptoms go away, still need to finish
treatment
– Make sure your partner(s) gets treated, so that
you do not pass an infection back and forth
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 Learn More!
• To learn more about this topic, and for links to articles
featuring more details, please read the full fact sheet on
this topic:
– Fact sheet: Sexually Transmitted Infections or Diseases (STIs
or STDs)
• For more fact sheets and to connect to our community of
women living with HIV:
– [Link]
– @[Link]
– [Link]/thewellproject
– [Link]/thewellprojecthiv/
– [Link]/@thewellprojecthiv
– [Link]/thewellprojecthiv
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