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Say you’re in a monogamous relationship or you’re always really, really careful when it comes to your sexual behaviour – you’re still at risk of getting an STI. If you are a sexually active young adult living in Canada, the clear answer to this question is an unambiguous yes! Yes, some people with common STIs can have symptoms like genital warts for HPV, lesions or blisters for genital herpes, and genital discharge and pain for chlamydia. But in many cases, a person with one of these STIs has no physical signs of the infection even though they can still transmit it.
In the chart, you will see some conservative estimates, based on the scientific literature, for what percentage of young adults in their twenties are currently infected with different STIs. Genital warts are common and often look like cauliflower-shaped growths or small hard lumps or skin tags. Once the warts are gone, you may still be infectious for some time until your body clears the virus.
Because some types of HPV can lead to cervical cancer, it is important for women to get regular Pap tests to detect any abnormal changes in the cells of your cervix. HPV is very common and you can carry and transmit an asymptomatic HPV infection long after you get it.
HSV is one of the most common STIs there is, and once you have the virus, it will stay with you even when you aren’t having an outbreak. Most HSV-2 infections, referred to as genital herpes, are the result of genital-to-genital contact. If you get infected, you may or may not have outbreaks, which are small painful blisters in the genital area.
If you think you are having a first outbreak, it’s important that you see a doctor immediately.
Most genital herpes infections don’t show any symptoms, so the infected person doesn’t know it’s there, but they can still transmit the virus.
Common among teenagers and young adults in their 20s, chlamydia is easy to treat once detected. Many people think that if they got chlamydia they would know it – that there would be some kind of unpleasant discharge or that it would hurt to urinate.
If left untreated, chlamydia can cause pelvic inflammatory disease, tubal infertility, chronic pelvic pain, ectopic pregnancy, and make you more susceptible to contracting HIV.
Chlamydia is actually quite easy to treat if it’s caught early, before doing any major damage to your reproductive system. Gonorrhea may not be as common as some other STIs, but if you have unprotected sex with someone who has it, there is a good chance you will be infected. Gonorrhea is very similar to chlamydia in that they are both bacterial infections and share comparable symptoms.
One major difference between the two is that symptoms often show up more quickly, sometimes within a few days. Gonorrhea can have profound negative health consequences, particularly for women, when not treated promptly.
If you have unprotected sex with an infected person, the chances that you will be infected are quite high. Most people infected with HBV will be left with few, if any, lasting health consequences; however, a small percentage of people can suffer significant liver damage as a result of the infection.
HBV is transmitted when infected saliva, blood, vaginal fluid, or semen (come) enters the blood stream. Hepatitis B has become less common in Canada in recent years, partly because many people have been vaccinated against it. If you have not been vaccinated against HBV and think you may be at risk, you should get tested for the virus and consider being vaccinated.
Human immunodeficiency virus (HIV), the cause of acquired immunodeficiency syndrome (AIDS) doesn’t get as much attention as it used to. Soon after a person has been infected with HIV they may experience flu-like symptoms, such as a fever or sore throat. As the HIV-infected person begins to develop AIDS, a number of symptoms and conditions may occur.
If you’re sexually active, getting tested for STIs is definitely a good idea, especially if you have had sex without a condom. If you are a sexually active woman, you should receive Pap testing (to detect abnormal changes to your cervix caused by HPV infection) as a regular part of your health care. The first thing you should know is that college and university health services and walk-in medical clinics do STI tests all the time.
Testing for chlamydia is pretty straightforward: a small swab is used to take a sample from the woman’s cervix or the opening of the man’s penis. Most HPV infections have no visible symptoms, so without visible genital warts, it’s very difficult to tell if you have HPV. The HIV test – also known as the AIDS test – is a blood test that determines if you have been infected with HIV. It takes three months after you have been infected with HIV for a blood test to detect HIV antibodies in your system. It will take 1 to 3 weeks for the results to come back and you will have to get them in-person.
Any physical contact between people brings some risk of disease or infection – the same is true of sexual contact and STIs. Having a plan means you’ve thought about your future, where you’re going, and what you need to do along the way. Many people even plan out things like what kind of relationship they want or when in their life they’d like to get married. It’s sitting down and deciding what you do and don’t want to do sexually over the short, medium and long-term.
If you don’t have an answer that rolls off your tongue maybe you should sit down and think about it. Condoms: easy to use, easy to buy – and they are very effective in preventing STI transmission and pregnancy. Consistently using latex, polyurethane or polyisoprene condoms is very effective in significantly reducing your risk of transmitting or becoming infected with an STI.
Laboratory tests have shown that latex, polyurethane or polyisoprene condoms block particles the size of HIV, HPV, HSV, chlamydia, and gonorrhea.
Also, if used correctly condoms are very effective in preventing pregnancy, making them one of the most effective contraceptives available. Let’s be clear: sex with condoms is not 100% risk free, but if you use condoms your STI risk will be much lower. Some people might feel a little awkward or embarrassed about talking about condoms with their partner. Maybe it’s as simple as whispering to partner: “I always use condoms” or “I’ve got condoms”. However you bring it up, it’s a good idea to plan out in advance when you will bring it up. Probably at some point before or soon after physical contact has begun but before clothes start to come off is best. If your partner seems reluctant the first thing you can say is “I want to be with you, but condoms are part of the package when you sleep with me”.
Especially if this is a first time partner, and you are still getting push back, it’s time to think about showing them the door. Tip: If you’re worried about losing an erection, don’t put the condom on while lying on your back – it’s easier for the blood to flow out of the penis.
The pill is a great method of birth control, but it does absolutely nothing in the way of protecting you against getting an STI.
Sometimes as two people become a couple they decide to use the oral contraceptive pill to prevent pregnancy.


If you’ve just gotten your prescription for the pill you can say to your partner, “I’m glad to be on the pill now.
If your partner doesn’t understand why you want to use condoms while you are on the pill or is pressuring you not to use condoms, you can say, “My doctor told me to keep using them. You’ve got many, many options when it comes to condom shopping – and picking out a few new ones to try is only half the fun. Condoms come in different shapes, sizes, textures and colours with a variety of lubricants for enhanced sensation. You definitely want to choose a condom that’s made with high quality materials that effectively block sperm and STIs, which means it needs to be made of either latex or polyurethane. If you have a latex allergy, and lots of people do, then polyurethane condoms are definitely your answer. Using a condom is simple – BUT incorrect usage can lead to condom slippage or breakage, which reduces their effectiveness! Immediately after ejaculation, hold the condom in place and withdraw the penis while it is still erect to avoid spilling semen. In many parts of eastern and southern Africa, AIDS isn't affecting only high-risk groups like sex workers, she explained.
High HIV infection rates, however, are just part of the problem facing those who are battling AIDS in the developing world. Celum is leading a pair of studies to determine if acyclovir, a drug used to reduce transmission of genital herpes, can reduce the transmission of HIV.
For the first study, the researchers will recruit 3,600 couples in which one partner is HIV-positive and the other is not, and in which the HIV-positive partner also has genital herpes. The study could shed light on the connection between HIV and the herpes simplex virus type 2, or HSV 2, which causes genital herpes. If successful, acyclovir would not only help keep people from contracting HIV and AIDS, it would also be less expensive than treating the disease after infection.
Researchers hope that the study will promote other methods for reducing HIV transmission between couples, Celum said, by incorporating intensive couples counseling. The study will counsel couples about condom use and ways to reduce risk of HIV transmission within the relationship.
The study will also assess biologic factors that affect the likelihood of HIV transmission, including virologic, immunologic, and genetic variants. The other study will work with HIV-negative people who have genital herpes to determine if taking acyclovir will make them less susceptible to being infected with HIV. Even if you consider yourself to be conservative and cautious when it comes to sexual behaviour, you may be at higher risk for STIs than you think. In fact, most cases of HPV, genital herpes, and chlamydia transmission involve a person with an asymptomatic infection passing it to an uninfected partner. This section provides some basic information on the most common STIs and what the implications for your health are. For example, it is estimated that up to 40% of sexually active young women may be infected with an STI by age 191 and up to 10.5% of people will have been infected with genital herpes by age 302. Prevalence of sexually transmitted infections among female adolescents aged 14 to 19 in the United States.
They can appear anywhere in the genital and rectal areas but can be very hard to see, so people often have them without knowing. If the Pap test detects these changes, doctors can treat it by removing the tissue well before it becomes cervical cancer. Although most people have been exposed to HISV-1 only a minority of people end up getting cold sores. If you are infected, but have no outbreaks, you can still transmit the virus to other people. Treatments like acyclovir, valacyclovir, and famciclovir have been developed which can shorten or stop outbreaks and reduce the chances of sexual transmission, but the virus will still remain. In addition to the blisters or sores, an initial outbreak often includes fever, swollen lymph nodes, headaches, fatigue, and muscle aches. Don’t wait around to see if the sores go away – quick treatment will reduce the length of the outbreak.
However, these symptoms don’t usually show up until 1 to 3 weeks after you’ve been infected.
These negative outcomes include Pelvic Inflammatory Disease (PID), ectopic pregnancy, and infertility.
Since a high proportion of people who have gonorrhea also have chlamydia, it’s likely you’ll also be tested for chlamydia if you have symptoms for gonorrhea.
So, if a current or past sexual partner informs you that they have been diagnosed with gonorrhea, it’s very important that you get tested and treatment right away.
When symptoms do show, they include: vomiting, flu-like symptoms, fatigue, loss of appetite, and yellowing of the skin and eyes. It’s likely that condoms reduce the risk of transmission because HBV sized viruses are too big to pass through latex, polyurethane or polyisoprene condoms.
Still, over 65,000 Canadians have tested positive for HIV, there are about 2,500 new HIV infections each year, and it is estimated that over a quarter of people with HIV in Canada don’t know they have it.
These symptoms will disappear and the person may have no further symptoms of the infection for up to 10 years or longer. So far, the most effective treatment is a combination of drugs called highly active antiretroviral therapy (HAART). If used consistently, latex, polyurethane or polyisoprene condoms are very effective in preventing HIV infection. It’s a routine, everyday thing for them so don’t hesitate to call to make an appointment or walk into the clinic to ask for STI testing. You will likely be asked some straightforward questions beginning with why you would like STI testing. Symptoms or no symptoms, be prepared to be asked some questions about your sexual behaviour so that the doctor or nurse will be able to determine if STI testing is appropriate and which tests to conduct. Yes, you may be asked some questions you’re not used to being asked, especially by strangers, but at the end of the day the most important thing is to get it checked out and, if necessary, properly diagnosed and treated so you can get on with your life.
Most cases have no symptoms, but if left untreated, can cause serious damage to your reproductive system. Using a swab, a sample is taken from the sore or blister and sent to a lab for a viral culture test which will determine whether it is HSV-1 (the cold sore virus) or HSV-2 (the genital herpes virus) or neither.
Since most HPV infections clear on their own over time, the need for developing an HPV test has not been a priority. If you test positive for the virus, you will need to have further blood tests to see if it has damaged your liver.
The test does not identify the virus itself but rather detects if your body has produced antibodies to the virus. So if you had unprotected sex a few days ago you are going to have to wait a couple of months before to be able to tell if you have been infected. There is a Rapid Test for HIV that some clinics offer that will give you the results right away. With a confidential test, the results are included in your medical file and only medical and health professionals, like the local medical officer of health are allowed to see unless you give written permission for them to share it with someone else. Giving precise estimates of the likelihood of contracting an STI from an infected partner as a result of sexual activity is, in most cases, impossible; in other words, it’s not an exact science. It should be used as an approximate guide to comparing the relative STI risks of different sexual acts.
But think about it: many of us plan out important parts of our life whether it’s financial and educational goals or things like physical fitness. It’s about deciding what’s right for you when it comes to sex and once you’ve done that you won’t have to make spur of the moment decisions about sex, which can be fueled by lust, alcohol, drugs, or emotions.
The only things more effective than condoms in reducing STI risk are to not have sex at all or to make sure that both you and your partner(s) are STI free – although that’s very difficult to do with absolute certainty.


And, studies comparing people who use condoms consistently with people who don’t use condoms during sex have found that consistent condom use reduces the risk of contracting HIV, HSV, HPV, chlamydia and gonorrhea.
The bottom line is that if you are a sexually active young adult, whether you are single or in a relationship, whether you have sex once in a while or every night, using condoms will reduce your risk of STI. Talking about condoms doesn’t have to break the mood, in fact it can put both partners at ease – now you both know sex is going to happen and it’s going to be protected. If your partner doesn’t want to use condoms with you they probably tried to talk their way out of using them with previous partners. The pill isn’t perfect and either of us could pass on an STI that we didn’t even know we had.
Fortunately, because latex, polyurethane and polyisoprene condoms are quite flexible and are designed to be “form-fitting”, fit is not a problem in most cases. Most of us are familiar with latex condoms so if you haven’t seen or touched a polyurethane condom, check it out. Take the time to read this section so you know you’re doing everything you can to stay safe! Lesions, pre-ejaculate secretions, semen, vaginal secretions and blood can all transmit infectious organisms. Be sure the rolled up ring is on the outside and leave space at the tip to hold semen when you ejaculate. Connie Celum walks through the cemeteries in Soweto, South Africa, she is starkly reminded of the AIDS epidemic gripping that country and many of its neighbors. Though many HIV-positive people in the United States and other developed countries receive life-extending care for their condition, only about 5 percent of the infected population is getting treatment in Africa, where an infection is tantamount to a death sentence.
A $30 million grant by the Bill & Melinda Gates Foundation will fund a study conducted at 12 sites in Africa and India. Half of the HIV-positive partners in these couples will receive acyclovir, while the other half will get a matching placebo.
Previous studies have shown that people with genital herpes are about twice as susceptible to HIV infection than the rest of the population, and those with both HSV 2 and HIV shed higher quantities of HIV in the genital tract. An approach like that is necessary in tackling HIV infection among people in stable relationships because that situation is different, for example, from trying to reduce HIV infection in groups of sex workers.
Both groups, those receiving acyclovir and those getting a placebo, will receive this counseling. The study will take place in Seattle, San Francisco, and New York, as well as at sites in Peru, Zimbabwe, Zambia, and South Africa.
These infections can have some serious implications for your health and well-being so this is something you should definitely pay attention to. You may be surprised to learn that many individual cases of STI have no symptoms right away or at the moment of contact. Even if you have only had a couple of sexual partners in your lifetime, there is a high probability that you have had sex with someone who has an STI. Seroprevalence of herpes simplex virus type 2 among persons aged 14-49 years, United States, 2005-2008.
HSV-1 can also infect the genital area, such as when a person shedding HSV-1 from their lips transmits to their partner’s genitals during oral sex.
Some people with chlamydia have no signs or symptoms of the infection so they can transmit the infection to their sex partners without knowing it. If you are treated it is important that your partner is too or else they’ll just give it back to you or to someone else. Using latex, polyurethane or polyisoprene condoms reduces the chances you will be infected.
During this time when a person has no symptoms, he or she can still transmit the virus to other people. As AIDS progresses, the person’s immune system is weakened and increasingly unable to fight off some types of disease. HAART has been effective in significantly extending the life-span of people living with HIV. The good news is that most colleges and universities have student health services where you can get tested for STIs. If you tell the doctor or nurse that you have symptoms, like sores or bumps on your genitals or an unusual discharge, they will want to look at your genital area. If you think you have contracted a particular STI you need to tell the doctor or nurse which one. It’s very important that your partner is tested and treated so that you do not pass the infection back and forth.
Testing is similar to the testing for chlamydia: a swab is used to take a sample from the cervix or penis opening. There is a DNA test for HPV but it is only used as a follow-up procedure for women over 30 years of age with abnormal Pap test results. However, if the rapid test is positive, you will need to have the regular test in order to confirm the results. However, if you apply for insurance you will need to supply your medical file, which will include your HIV test results. If you want to get an HIV test and want it to be anonymous check with local clinics in your area to see if they offer it. For example, the chart indicates that using a condom during intercourse is “lower risk” for various STIs than having intercourse without a condom. Maybe that’s why so many people end up with STIs or wake up the next morning regretting the night before.
By bringing up the topic of condom use you are sending a loud and clear signal to someone you are interested in: yes, you want to have sex and yes you’re smart enough to take care of your sexual health.
If your partner is someone you have been getting to know for a while and this is the first time you’re going to have sex, you can say something like “I saw these at the student health centre. By that time, it’s all about passion and pleasure and it’s much easier to forget or put it out of your mind, especially if you’ve had a few drinks.
By now you should know how common STIs with no symptoms are and be thinking that continuing to use condoms is a good idea. But if you or your partner are particular, there are many different shapes and sizes to choose from. The material isn’t quite as flexible as latex, but polyurethane is thinner and transfers heat more easily. Or pick up a few different kinds and have some fun testing them until you find the one that’s just right for the two of you.
A grant from the National Institutes of Health will fund another study of populations in the United States, Peru, and three sites in southern Africa. All of the couples will receive intensive counseling on traditional prevention, such as condom use, and get free condoms and bacterial STD treatment. The annual cost is about the same as for one month of generic antiretrovirals used to treat HIV-infected patients.
Celum and her colleagues are recruiting subjects for that study, and expect to finish recruitment by the summer of 2005. The doctor may apply a white vinegar solution: if the growths turn white it is an indication that they are genital warts. Research will help determine if acyclovir can help cut down on HIV transmission in addition to preventing the spread of herpes. If the HIV infection has progressed to full blown AIDS, the person usually dies within a few years. Pap tests, which women should be getting regularly, are designed to detect cervical abnormalities that are usually caused by an HPV infection of the cervix.



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